Helicopters in SAR - Advanced

Helicopters
In Search and Rescue

Advanced Level
Mountain Rescue Association

Air Zermatt
MOUNTAIN RESCUE ASSOCIATION
HELICOPTERS IN SEARCH AND RESCUE

Advanced Level
By Charley Shimanski and Dr. Charlie Mize

© Mountain Rescue Association and Air Zermatt
Table of Contents
Objective ................................................................................................................ 1
About the Authors ................................................................................................. 1
Part 1 – Rescue Helicopters and Crew ................................................................. 1
Introduction ................................................................................................................................................................................ 1
Human External Cargo (HEC) ............................................................................................................................................... 2
Types of Rescue Helicopters ................................................................................................................................................... 2
Emergency Medical Services Helicopters (HEMS) ............................................................................................................. 3
SAR and HEMS Helicopters ................................................................................................................................................... 4
Definition of Rescue Helicopter Personnel .......................................................................................................................... 4
Types and Definitions of HEC Systems ............................................................................................................................... 6
Hoists ........................................................................................................................................................................................... 8
Short Hauls ................................................................................................................................................................................. 9
Mission Planning...................................................................................................................................................................... 10
Pre-Operational Briefing ........................................................................................................................................................ 12
Post Event Debrief.................................................................................................................................................................. 13
Lessons Learned? Not Necessarily ...................................................................................................................................... 13
Part 2 – Equipment for HEC Operations ........................................................... 14
Specialized Equipment ........................................................................................................................................................... 14
Equipment Unique to Hoist Operations ............................................................................................................................. 16
Equipment Unique to Short-Haul Operations ................................................................................................................... 18
Equipment for Securing and Transporting Injured and Uninjured Subjects ................................................................ 19
Equipment for Transporting Severely Injured Subjects ................................................................................................... 19
Equipment for Extricating Uninjured Subjects.................................................................................................................. 20
Personal Equipment for Rescue Personnel (Part One) .................................................................................................... 20
Personnel Carrying Device Systems (PCDS) ...................................................................................................................... 21
Helmets...................................................................................................................................................................................... 22
Other Personal Protective Equipment (PPE) .................................................................................................................... 23
Carabiners for HEC Rescuers ............................................................................................................................................... 24
Part 3 – Principles of Flight ................................................................................ 26
When to Use Hoist vs. Short-Haul....................................................................................................................................... 26
Execution of a Hoist Operation ........................................................................................................................................... 27
Execution of a Short-Haul Operation ................................................................................................................................. 30
Radio Communication for HEC Operations ..................................................................................................................... 33
Hand Signals for External Loads .......................................................................................................................................... 33
Operational Considerations for HEC Operations ............................................................................................................. 34
Part 4 – Helicopter Management and Safety Precautions ................................. 37
Helicopter Service Ceiling, Hover and Flight ..................................................................................................................... 37
Aerodynamics of Human External Cargo ........................................................................................................................... 38
Hot-Loading/Unloading and Power-on Landings ............................................................................................................ 42
One-Skid and Toe-In Landings ............................................................................................................................................ 43
Hover Insertion and Extraction ............................................................................................................................................ 43
Complex Loading and Unloading - Is There Another Way? ........................................................................................... 47
Winter Landings in Snow ....................................................................................................................................................... 48
Part 5 – Search and Rescue Helicopter Operations ........................................... 50
HEC Rescues on Near-Vertical Walls ................................................................................................................................. 50
Night Operations ..................................................................................................................................................................... 51
CONCLUSION................................................................................................... 56
ACKNOWLEDGEMENTS ................................................................................ 56
Additional Materials ................................................................................................................................................................ 57
H E L I C O P T E R S I N S E A R C H A N D R E S C U E
A D V A N C E D L E V E L
Objective
This program is designed to provide information required by mountain rescue and personnel for safe
operation in advanced helicopter operations, including those in which rescuers are suspended beneath the
helicopter while in flight.
At the conclusion of this program, students should be able to:
 Understand techniques that contribute to safe and effective use of helicopters in complex operations
involving human external cargo (HEC),
 Understand the basic functions and safety features of HEC operations,
 Identify key elements of aerodynamics and helicopter operations during hoist and short-haul
operations, and
 Implement helicopter management and safety precautions in complex helicopter operations
About the Authors

Charley Shimanski
Charley Shimanski is President of the Air Rescue Commission for the
International Commission for Alpine Rescue. He is a 30-year member of
Alpine Rescue Team and Mountain Rescue Program Coordinator, Flight
For Life Colorado. He is also Past President and Education Director for
the Mountain Rescue Association, a national organization of rescue
mountaineers. Charley has participated in hundreds of rescues among
Colorado’s highest peaks, and has consulted rescue mountaineers,
mountain guides, and climbers throughout the world.
Dr. Charlie Mize

Charles Haviland Mize, BA MD, is a specialist in emergency medicine and
resuscitation and is a leading expert on the retrieval of critically-ill and
injured patients from austere environments at high-altitude. He has led
numerous helicopter rescue operations throughout the Himalaya. He is a
co-founding member of BearBadger, a physician-led team that undertakes
high-risk patient retrieval, and is the founder of Bhutan Emergency
Aeromedical Retrieval, the Kingdom of Bhutan’s pre-hospital helicopter
critical care and mountain rescue team.
Contributors: Oliver Kreuzer and Air Zermatt

We wish to recognize the contributions of the leadership of Air Zermatt
and its world-renown Air Zermatt Training Center. In particular, Oliver
Kreuzer played a pivotal role in the development of this program, both
through his hands on education and his vast experience. Oliver is a 13-year
veteran and Flight Paramedic with Air Zermatt and a leader of their
training program since 2010. Oliver is also a flight medic in the US Army
Reserve. The authors deeply appreciate the wisdom and insight of Oliver,
for his inspiration, dedication, and thoughtful instruction.
i
1
Part
Part 1 – Rescue Helicopters and Crew
Photo: Air Zermatt
Introduction
For many years, helicopter search and rescue (SAR) operations made the treatment onboard of the lost, ill or
injured their primary focus. SAR missions initially limited the use of helicopter flight to support ground-based
operations and to provide rapid transport of the critically-ill or injured to definitive medical care.
In the past few decades, however, SAR personnel on the ground have increasingly confronted complicated
terrain features and/or environmental conditions (avalanche, flood, etc.) that render access, stabilization, and
evacuation of an injured or stranded subject either impossible or dangerous. Rescue in these circumstances
demands action certain to put the lives of rescuers on the ground at high risk. Faced with these challenges,
emergency responders have turned to rescue helicopters and their specialized crews to provide a novel form
of rescue. These techniques include lowering, raising, and/or transporting rescuers and subjects suspended
below the aircraft while in flight. The development of SAR rescue helicopters capable of inserting and
extracting rescuers by hoist and short-haul has made it possible for helicopter rescue personnel to perform
complex rescue operations in terrain and weather where a helicopter landing is out of the question.
Of course, rescue personnel do not limit their use of helicopter rescue to these challenging techniques; the
use of helicopter aviation in SAR and rescue has a wide scope.
This training will address the basic components of helicopter rescues that include these specialized rescue
techniques. It is intended for paid and volunteer rescue professionals who work in rescue programs that train
in and use these technical helicopter rescue techniques.
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Human External Cargo (HEC)

Specially-equipped SAR helicopters may include external
cargo capability including “human external cargo,”
commonly referred to as “HEC.” The term HEC refers to
hoisting and short-haul operations used to transport SAR
personnel or rescue subjects to and from difficult-to-access
locations, or when time is short and rapid extrication is
critical. While many rescue programs employ hoisting
operations, numerous rescue programs also transport
human cargo by short-haul operation.
The US Federal Aviation Administration has formally

defined HEC in FAA AC 27/29.865 as “A person(s) that at
some point in the operation is carried external to the rotorcraft. For
the purpose of this training, we will refer to HEC as "the
transport of individuals outside the aircraft with a simple
and/or complex Personnel Carrying Device System (PCDS)
connected to the cargo hook or hoist."
In Part One, we define the types of rescue helicopters used,

and the categories of rescue crewmembers that comprise a
Photo: U.S. Army National Guard Short Haul by 1st technical helicopter rescue unit.
Lt. Kara Siepmann)
Types of Rescue Helicopters

In this training, we will focus on two primary categories
of helicopters performing SAR work that may include
technical rescues and human external cargo, these are:
 Search and Rescue (SAR) helicopters
 Emergency Medical Services helicopters
(HEMS)
For simplicity, we will refer to both of these types of

helicopters as “rescue helicopters” throughout this
training, except when the distinction is important.
Each type of helicopter is critical in life-saving SAR Photo: Charley Shimanski

work, and may share overlapping scopes of work with
its counterpart. While not common, some SAR
helicopters are equipped to provide advanced life support and critical care. This is particularly true in military
operations, as well as in rescue programs serving a high volume of backcountry responses in rugged terrain,
such as the European Alps. In these cases, the high level of knowledge, experience and advanced patient care
capability these units bring can significantly benefit the victim/patient.
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Search and Rescue (SAR) Helicopters

Numerous helicopter programs worldwide possess a specialized
SAR capability. These programs may operate under the
authority of government agencies (federal, state, local or
military), or private operators that may include hospitals or
other providers.
SAR Personnel on board

The crew of SAR Helicopters include rescue specialists in
addition to their pilot(s). These rescue specialists can include
volunteer or paid SAR team members, mountain guides, and/or
advanced life support/critical care emergency medical
Photo: Ahlstrom Air/Rocky Mountain House providers. Many SAR helicopter programs work closely with
SAR (Canada) the local SAR team, integrating and training the SAR team
members into their helicopter operations.
Specialized Helicopter Rescue Equipment

In addition to HEC capability, SAR helicopters are often
equipped with specialized tools, collectively referred to as
"remote sensing" equipment/devices,” to empower rescue
operations. These tools include the RECCO detectors, both
handheld and helicopter mounted, a Girsberger long range
Helicopter Antenna System, the Lifeseeker System, and the
Forward Looking Infrared (FLIR), which detects the heat
signatures of objects on the ground.
Emergency Medical Services Helicopters (HEMS)

There are hundreds of critical care medical helicopters
worldwide. These helicopter programs and their crews are
called Helicopter Emergency Medical Services (HEMS). While
the use of the title HEMS is near-universal, the US Federal
Aviation Administration (FAA) also refers to these aircraft as
Helicopter Air Ambulances (HAA). These helicopters carry
both the medical equipment and the personnel to provide
advanced life support (ALS). Depending on their response
area, geography, helicopter type, and medical capability, some
HEMS helicopters will serve a simple air ambulance while
others will act as a prehospital intensive care unit, providing
H145-Interior from Nicolas Gouhier-
Airbus/Vertical Magazine, state-of-the-art critical care (ECMO, cardiac pacing, balloon
pumps, etc.).
The primary difference between a SAR and HEMS helicopter is the rescue equipment onboard and the
medical and technical rescue qualifications of the crewmembers who provide the medical care. HEMS
crewmembers are highly trained in critical care and usually flight paramedics, nurses and/or physicians. The
US is mainly operating with a nurse/paramedic crew, where European countries are usually seen
physician/paramedic-based teams.
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For some time, HEMS programs have trained with local

SAR teams to develop programs to integrate mountain
rescuer specialists into their helicopter rescue operations.
Flight For Life Colorado, the first HEMS program in the
United States, was created partly as a result of a
mountain rescue incident following the 1970 crash of a
plane carrying members of the Wichita State University
Football team. The Flight For Life program has now
evolved into a highly sophisticated and technical
program that integrates rescue mountaineers as
crewmembers in three different rescuer integration
programs.
Photo: Flight For Life
HEMS programs that collaborate and partner with SAR
teams in mountain and backcountry settings often provide training for their own medical crewmembers that
includes operating and surviving in austere environments. This can include education on high-altitude
physiology and the provision of care in severe weather, circumstances certain to present challenges to both
patient care and crew safety.
SAR and HEMS Helicopters

It is important to emphasize the significant overlap in the work of SAR and HEMS helicopters. Many SAR
helicopters possess the ability to provide critical care and
emergency medicine, and many HEMS aircraft are
equipped with SAR and/or HEC capabilities.
In a few cases, rescue agencies have both types of rescue

helicopters, affording them the ability to launch one SAR
helicopter to begin a rescue operation, followed by a more
specialized HEMS helicopter to support the subject. In
the case of Air Zermatt in Switzerland, the “rescue
helicopter” first launched might be an Airbus AS350-B3e
(aka H125) which they use initially to drop rescuers at the
scene. The second helicopter, a Bell 429 HEMS-
configured aircraft, can then support with medical
personnel and equipment.
Definition of Rescue Helicopter Personnel

In its Draft “Hoist Operator Training Guide,” (LINK HERE) the European Safety Promotion Network -
Rotorcraft (ESPN-R) defines HEC operations as follows:
“During the flight, Pilots, Hoist Operators, Rescuers, Medical Personnel and other human external cargo (HEC) are
identified as a group of interdependent individuals working together to complete a specific task. The Crew, considered as
a team, must depend on each other’s knowledge, skills, and abilities to achieve the same goal.”
Job titles and definitions of rescue helicopter personnel can be as diverse as the programs themselves. In this
section, we detail the most commonly used terms.
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Pilots
Of course, all helicopter programs require a pilot. In
circumstances where the operational complexity or
aircraft requires more than a single pilot, one will be
designated as the Pilot in Command (PIC) and the other
will be designated as the Second in Command (SIC), a
non-flying pilot who sits opposite the PIC, with his/her
own set of controls. While the PIC handles flying the
aircraft, the SIC has important duties, often including
communication and navigation.
If there is only a single pilot, that pilot is the PIC. The

PIC is certified in the specific type of helicopter he or she Air Zermatt veteran rescue pilot and CEO Gerold
flies. Biner. Photo: Air Zermatt
The excellence of a helicopter rescue program is tied to the caliber and experience of its pilots. Flight hours
are an important marker of experience, but not all flight hours are equal. A pilot who flies offshore daily (aka
"point-to-point" flying; 3 hours out, 3 hours back) would log hours of flight, but few crucial hours of HEC
operations. A pilot who flies firefighting operations, making many bucket drops, gains valuable experience
more pertinent to the safe execution of external load operations.
HEC work is all about repetition, as repetition is the key to proficiency. HEC pilots with little experience
with placement of precision external loads in flight will be less prepared to meet the unforeseen challenges of
a rescue operation. Pilots cannot master a technique with minimal experience. While there are many training
programs that pilots can attend, programs should consider additional training opportunities to increase the
amount of experience their pilots and crew receive:
When opportunities exist for programs to train with neighboring programs, these training exchanges should
be encouraged. At the same time, there may be opportunities form one agency to support another - flying in
personnel and material to do lookout maintenance for the forest service, dropping off material for repeater
towers etc.
Programs that also perform firefighting duties can use water bucket drop training to give their pilots
experience using non-human cargo in an environment where it is difficult to gain visual reference to indicate
altitude. This is valuable experience without the need for daily, real-world HEC operations.
In bringing clients to isolated runs, heli-ski pilots can also gain experience on how to determine landing
conditions at different altitudes. These pilots often
land many times in a single day.
Non-Pilot SAR/HEC Personnel

Rescue helicopter programs worldwide employ
different language to describe their non-pilot rescue
crewmembers. Many of these terms are commonly
used, but can vary geographically or within different
types of rescue services.
Terms most commonly used include:

Photo: Yosemite National Park (USA) Search and Rescue
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Air Operations Ground Support Team Members

Rescuers specifically trained to support air operations, and especially HEC operations, from the ground.
Crew Chief
The crewmember who oversees all activities in the rear of the helicopter.
Crewmember/Rescue Specialist
Any non-pilot member of the helicopter rescue team, including those with or without medical capability.
Medic / HEMS Crewmember

Typically, the flight paramedic, flight nurse crewmember, but also can be used to refer to any crewmember
with any emergency medical certification. The European Union Aviation Safety Agency (EASA) describes
this person as a HEMS Technical Crew Member (HEMS TCM), “a technical crew member who is assigned
to a HEMS flight for the purpose of attending to any person in need of medical assistance, carried in the
helicopter and assisting the pilot during the mission.
Helicopter Hoist Operator (aka “HHO” or “HO”)

The rescuer on board the helicopter that operates the hoist
mechanism, usually from the back of the aircraft. EASA describes
this person as “Helicopter Hoist Operator Technical Crew Member
(HHO TCM); a technical crew member who performs assigned
duties relating to the operation of a hoist. lt is common practice
that both roles are assigned to one single person, who would
perform these tasks according (sic) the needs of the mission.”
PJ
Pararescuemen, U.S. Air Force Special Operations Command
(AFSOC) and Air Combat Command (ACC) personnel who are
involved in search, rescue, recovery and medical treatment in rescue
operations.
Spotter
A rescuer whose primary role is to observe and augment the team’s
situational awareness. Sometimes the role includes responsibility for
the actions of the rescue personnel under observation.
Photo: Air Zermatt/Vertical Magazine
Types and Definitions of HEC Systems

HEC aircraft largely deliver and retrieve rescuers or injured subjects through two methods:
 Hoist (also known in British usage as “winch”), and
 Short-Haul (also known as “longline”)
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Photo: Priority 1 Air Rescue Photo: Charley Shimanski
Throughout this training, we will use the terms “hoist” and “short-haul” in lieu of “winch” and “longline.”
Vertical Reference and the Differences between Hoist and Short-Haul

Operations
Both hoist and short-haul operations enable a rescue helicopter crew to insert or extract rescuers and subjects
from sites where safe landing is impossible. There are key differences between hoist and short-haul
operations, with each method carrying its own advantages and limitations. The most significant of these
differences is the position of the line itself. In short-haul operations, rescuers and subjects are suspended on
a fixed line whose length cannot be adjusted in-flight. During short-haul operations, whatever is suspended
on the line - whether human operators, rescue subjects or inanimate cargo - moves in direct response to the
movement of the aircraft. The pilot thus directs all movement of the short-haul line in the horizontal and
vertical axis. By contrast, hoist operations provide another element of control. While the pilot still positions
the aircraft, the hoist operator can raise or lower human cargo independently of the aircraft’s position
through use of the mechanical hoist system.
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Both short-haul and hoist can be performed under high fidelity

direct or indirect vertical reference. During Direct Vertical
Reference operations, the pilot is able to see the rescuer/load
(through direct visualization or a load mirror) and can thereby
properly position the aircraft for the short-haul or hoist. By
contrast, Indirect Vertical Reference performance occurs when
the pilot is unable to see the rescuer/load and is dependent on
a hoist operator, crew chief, or spotter to help the pilot
position the aircraft over the rescue site.
While hoisting operations reduce the time that rescuers are

exposed beneath the helicopter - many hoist mechanisms allow
the rescuer and subject on the hoist cable to be brought into
the aircraft cabin- short-hauls require less weight to operate. A
lower operating weight means more available power margin.
This difference can be significant: some short-haul operations
can lift 4-6 victims at once, while rescue hoists are often
limited to roughly 600 pounds or less (a limitation placed on
the rescue hoist by the manufacturer, which therefore takes
into consideration everything from the installation bracket to
the hoist mechanism and cable). In addition, short-haul
programs require less program maintenance and crew Photo: Air Zermatt
coordination.
For those programs that maintain BOTH a hoist and short-haul program, the decision of whether to perform
a hoist or a short-haul operation can depend on many variables. These include the availability of each
platform, the scheduled and unscheduled maintenance of hoist equipment and aircraft, the location of the
rescue and the challenge that location presents, as well as the power, availability and skills of air and ground
crews, the patient condition, and the number of victims to be rescued.
Hoists
The use of rescue hoist systems can reduce the amount of time human external cargo remains exposed
outside the aircraft by enabling the pilot and crew to insert and extract rescuers and injured subjects and bring
them into the aircraft quickly. Hoist systems also make it possible to extract a subject over terrain where
landing would be unsafe and ground rescues unlikely to succeed.
Most hoist programs are designed to lift rescuers and a

patient up to the aircraft door where they can then be
loaded directly into the aircraft. Internally mounted hoist
mechanisms are designed to pivot inside the aircraft once
the load has been fully raised to enable the safe transfer
of human cargo from the hoist line to the aircraft cabin.
Alternatively, the human cargo is brought into the aircraft
by the rescuer, crew chief and/or medic. Some hoist
programs lift the rescuer and patient only to the
helicopter skids, and require landing to fully transfer the
rescuer and patient inside the aircraft. Cabin space
Photo: AH+RT/Vertical Magazine
limitations often dictate which loading strategy a team will
employ.
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Center of Gravity
Center of gravity (CG) is a key concern with hoist operations.
Consider, for example, a hoist-equipped helicopter with a
pilot sitting on the right side, the hoist mechanism on the
right side, the hoist operator on the right side, and a patient
and rescuer being hoisted onto the aircraft on the right-side
of the aircraft. For this reason, crews need to be careful not
to overcome/exceed the lateral CG. This can be
accomplished by loading one subject at a time, moving any
incoming subjects to the opposite side of the aircraft,
positioning any additional crew members on the opposite side
of aircraft, etc. Graphic: Charley Shimanski © MRA
Difficulties with Hoist Operations

Hoist operations present important challenges, to include:
 Hoist programs require an experienced pilot AND an experienced hoist operator.
 The addition of a hoist operator increases the required payload for the operation.
 There is a greater training burden on programs with a hoist system to ensure the teams executing
hoist operations can do so in a safe, efficient, and methodical way.
Short Hauls
It is important to remember that the name “short-
haul” refers to the short duration of time it takes to
perform the HEC operation, not to the length of the
rope used. For most programs, the short-haul line
measures between 30 and 60 meters. Although
some short-haul operations can require lines as long
as 200 meters, the 30-60 meter length is the best
compromise for most operations. Lines between 30
and 60 meters are long enough to be less affected by
rotor wash (vs. shorter lines) but remain short
enough to enable accurate positioning of the line (vs.
longer lines).
Short-haul programs offer several advantages when

compared to hoist operations. These include:
 Short-haul lines and load are much less likely to
compromise the aircraft’s center of gravity.
 The suspension of load under the center of the
aircraft reduces its exposure to rotor wash/flow.
 Because there is no hoist operator, short-haul
operations require less weight.
 Short-haul lines can be extended to much greater
lengths than can hoist cables.
Photo: Bild am Sonntag Magazine/Christian Spreitz
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Limitations of Short-Hauls
The benefits of short-haul programs are many: lower risk, lower training burden, less equipment and lower
cost. Still, inherent to short-haul operations are several important limitations, which include:
Night dramatically increases the difficulty of short-hauls. The recognition and assessment of hazards and the
response to emergency situations are all complicated by night.
Short-hauls are more difficult to place compared to hoist operations if vertical reference is not possible.
Vertical reference presents a challenge for the pilot, spotter, and crew chief, and can require additional
training in verbal communication when operational conditions preclude accurate visual orientation.
Short-hauls require more time to deploy than do hoist operations.
Mission Planning
While all helicopter rescue operations require careful planning, none require planning more than those
involving humans suspended outside of the aircraft. A meticulous study of weather and terrain maps by the
pilot is key prior to flight operations, and a discussion by pilots and crewmembers of prior rescues and rescue
attempts made in the same or in a geographically similar area often adds value.
Mission Pre-Planning and Inter-

Agency Coordination
If a HEC helicopter rescue mission is in support
of another agency (i.e., law enforcement or public
land management agency), the pilot and crew may
wish to land near an incident command post or
staging area to discuss/brief the intended
operation with the incident leadership before
carrying out the task.
Reconnaissance Flight
Once airborne, the pilot and crew should take the
time to perform a “reconnaissance flight” so that
Helicopter rescue veteran Drew Davis briefing US Army pilot.
all involved can gain situational awareness and
Photo: Charley Shimanski discuss what they see and anything that might
concern them (and what data their intuition brings
to the moment). This gives the crew time to
determine the correct course (and sequence) of action, and to assess environmental and other factors that
may impact aircraft and/or crewmember performance. All on board can use this reconnaissance flight to
evaluate visible hazards including trees, wires, slope angles, civilians on scene, other aircraft, etc.
For a short-haul operation, the reconnaissance will also guide the pilot and crew in determining a suitable
helispot from which to stage and prepare the short-haul equipment. For short-haul, hoist, and hover load
operations, the pilot can use the reconnaissance flight to perform a power check to determine available power
as well.
When combined with careful mission planning, the data collected during the reconnaissance flight will inform
the pilot, crew, and incident command team of the best and safest course of action for the rescue response.
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Risk Assessment
There is an important distinction between risk
management and risk assessment. While
helicopter rescue programs work to reduce risk
through careful attention to equipment and
human behavior, each rescue presents unique
elements that go beyond a program’s equipment,
personnel, and training. Weather, terrain, and
other operating conditions add risks unique to
each operation. Successful mitigation of these
risks requires that helicopter rescue teams
carefully search for, identify and evaluate all
possible hazards before planning a rescue.
Photo: Bob Wagner
This “real time” risk assessment is an essential
part of every HEC operation. Risk assessment is not an exact science. However, helicopter rescue operations
have moved away from casual, purely subjective estimates of risk towards more rigorous risk analyses that are
both more objective and more quantifiable.
The most widely used risk assessment tools follow a “GREEN-AMBER-RED” (aka “GAR”) model, which
produces a “risk score” based on several inputs from users. As a rescue operational plan is developed, rescue
team members use the GAR program to rate the risk based on several factors. For most GAR tools, these
factors include:
 The personnel involved in the rescue (leadership, qualifications, experience)
 The rescue plan (is it known, hurried, complex, is there consensus?)
 The rescue environment (weather, terrain, altitude)
Ideally, several rescuers input their personal “ratings” into the

GAR model, and upon completion, the rescue team evaluates
the aggregate “risk score” in its entirety, as well as any
composite outlier scores from each individual. This process
should take only a matter of minutes, and produces a highly
valuable assessment variable when the entire team participates
in the final evaluation of the aggregate and composite scores.
The National Park Service (USA) Helicopter Short-Haul
Operations Plan maintains that GAR programs, “are used to Photo: National Park Service (USA)
open critical conversations and prompt individuals involved to
consider the added risk of a helicopter short-haul.”
Ken Phillips, author of “Helicopter Rescue Techniques – Civilian Public Safety and Military Helicopter
Rescue Operations,” describes this model and defines why a GAR procedure really works:
“The ability to assign numerical scores or color codes in the GAR Model is not the key ingredient in how this process
serves to perform effective risk assessment. The key ingredient occurs when team members discuss their post-scoring
results together, because it generates valuable discussion toward understanding the risks and how the team will manage
them. Ultimately, it slows down the operational tempo and forces rescuers to carefully think rather than simply react.”
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GAR Programs
Two GAR programs
have become widely
used in the SAR
community, each of
which offers a special
app for smartphones.
They are:
Risk: SPE, ORMA,

and GAR Calculator
(◄◄◄ ON THE
LEFT) by the
National Park
Service, Department
of the Interior (USA)
(NOTE: A formal
GAR Risk
Assessment is
required for all Park
Service rescue short-
hauls.) (LINK
HERE)
RADeMS (ON THE

RIGHT►►►)
by the British
Columbia Search and
Rescue Association,
(Canada) (LINK
HERE)
Pre-Operational Briefing
Prior to the initiation of a rescue operation, the pilot,
onboard crewmembers, and rescue personnel should
engage in a pre-flight briefing. This briefing affords the
opportunity for members of the team to articulate their
personal assignments and roles, and their expectations of
the mission. The pre-operational briefing should consider
contingency plans and the events that would prompt them.
The team should anticipate any scenario that will require
the team to adapt its plan, and what that adaptation will
be. (e.g., What if ground-to-air communication is lost?
What if onboard communication is lost? What if weather
deteriorates after insertion of rescuers to the scene?). Photo: Bild am Sonntag Magazine/Christian Spreitz
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Øyvind Henningsen, Team Coordinator and Rescue Technician with the Snohomish County Helicopter
Rescue Team, states, “At times, we also do a pre-operational rehearsal, particularly if it is a high-risk, low-
frequency operation; for instance, picking off a climber on a rock wall. We would rehearse this several times
before taking off.”
“Talk-Through, Walk-Through”
A “Talk-Through, Walk-Through” pre-flight briefing can occur alongside the aircraft, and enables each
participant to express any concerns they have about the proposed plan. At the end of the Talk-Through,
Walk-Through, each rescuer should then take a moment of intentional silence to regain situational awareness
and reflect on his/her particular role in the coming operation.
Post Event Debrief

There are many names for a debrief that occurs
immediately following a helicopter rescue,
including “After-Action Review (AAR),” “Hot
Wash,” or simply “debrief.” Regardless of its
name, the debrief that occurs immediately
following a rescue is a critical element of team
performance and improvement. To be effective,
this debrief should create a safe space for open and
transparent dialogue, and then encourage all
involved to share and reflect while the rescue
remains fresh in the mind. Ken Phillips describes
Photo: Alpine Rescue Team, Colorado (USA) AARs well:
The overall goal of any rescue review is to improve

future responses, which prevents repeating known deficiencies and operational shortcomings. Conducting an
after-action review (AAR) immediately at the conclusion of the rescue effectively captures feedback from all
involved personnel. The strength of immediacy conducting the review is that personnel are actually more
receptive then to discussing any flaws in the operation. With the passage of time, personnel develop mental
justifications for less than optimal performance and are less receptive to discussions critical of their actions.
Lessons Learned? Not Necessarily

For decades, rescuers have used the term “Lessons Learned” in their after-action reviews to describe
corrective actions they might take after an incident or accident. The problematic character of this usage is in
its implicit suggestion that naming the corrective action alone is sufficient: the lesson is “learned” after the
error has been identified. The authors of this text believe nothing could be further from the truth. Incidents
and accidents have lessons to teach, but to learn those lessons - to improve the safety of helicopter rescue
operations - demands reflection and action. They demand the implementation of new protocols, training and
equipment and, sometimes, a change to an entire operational culture. For this reason, we suggest that
“Lessons Learned” be abandoned in favor of “Lessons Taught.”
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2
Part
Part 2 – Equipment for HEC Operations

Successful SAR and HEMS operations require more than the helicopters themselves. They require specialized
equipment that are fundamental to the safe completion of HEC missions. This lesson will explore these
essential components.
Specialized Equipment
Suspending rescuers and/or subjects beneath a helicopter in flight is a dangerous operation, one that requires
specialized equipment. Certain pieces of equipment are essential for both hoist and short-haul operations
while other pieces are unique to one or the other.
Standard Equipment for Both Hoist and Short-Haul Operations
Helicopter Hoist Hook

At the end of the cable is the “hoist hook,” a
specialized assembly that usually includes a safety-
gated large hook and a much smaller equipment ring
(also referred to as “utility eye,” or “eyelet”) that is
used as an attachment point for equipment, static
discharge cables, hook weight bag, etc.
It is important that rescue personnel connect

themselves ONLY to the larger safety-gated hook.
The smaller equipment ring (and smaller gated-hook, if
one exists) must NOT be used for personnel, as these
pieces are not rated for human loads. Rather, the
equipment ring is intended for lighter utility loads such
as trail lines, tag lines, static discharge cables, and
weight bags. While the utility eye can take higher
loads, using them as primary connection points is not
recommended as the hook will load off-center. This
places an offset strain on the cable that can, over time,
cause cable damage at the hoist hook/cable
connection point. Hooks should be loaded in the
main hook body to ensure a centered load. Photo: Eva Sophia Shimanski/Air Zermatt
Prompted by rescue accidents, many programs have transitioned to rescue hooks that include an auto-locking
gate, an additional safety feature that provides protection from accidental “dynamic rollout.” All programs
14
should strongly consider its use. According to the US Federal

Aviation Administration (FAA), dynamic ring rollout is a
condition that results from, “the unintended release of the
primary engaging ring from the winch (hoist) hook that may
occur subsequent to a pause in the winching (hoisting)
sequence.” When the connecting ring in a rescue system and
the gated rescue hook are temporarily relieved of the load, it is
possible for the connecting ring to flip over the tip of the hook
and come to rest on the spring-loaded gate. Once the weight
of the load is re-applied, it is possible for the connecting ring to
force open the spring- loaded gate, enabling the connecting ring to disconnect from the gated rescue hook.
US-based Lifesaving Systems offer an excellent demonstration of dynamic ring rollout in the video below.
According to a FAA Safety Alert for Operators (SAFO-16015):
Winching and longline operators should:

 Develop procedures which list the specific D-Rings or equipment which may be attached to a specific rescue hook
wherein the possibility of D-Ring reversal is physically impossible.
 Use only rescue hooks which have a mechanical locking keeper or guards to prevent D-ring reversal or dynamic
roll-out.
 Ensure initial and recurrent winch operational training is tailored for each helicopter type and winch combination
and is conducted on a regular basis.
 Operate and maintain winches, hooks, and harnesses in accordance with approved data.
It is the responsibility of every rescuer involved in HEC operation to understand the concept of "ring
geometry" to prevent dynamic rollout. As Ken Phillips reiterates, “Just because a ring fits a hook does not
mean it should be used.”
Connecting Hardware
Most HEC programs have a mechanism to
carry multiple rescuers at the end of their hoist
or short-haul system at the same time, thereby
increasing the efficiency of the transport of
rescuers to a scene. Briefly, this specialized
equipment is connected between the rescue
hook and the rescuers so that multiple rescuers
can be suspended from the rescue hook in a
manner that increases safety and reduces
human error. This connecting hardware will be
explored in greater detail later in this training.
Photo: Vertical Magazine/Air Zermatt
Static Discharge Cables

Rescue helicopters can generate significant amounts of static electricity while in hover. This is especially true
of larger helicopters, as well as helicopters operating under certain types of weather: in dry climates, especially
with blowing snow for dust, in snowfall, in mist, or near a thunder storm. This static electricity becomes a
danger to rescuers if they touch the rescue hook at the end of a hoist or short-haul line as it approaches from
the air, or if they are lowered to the ground at the end of a line. The static discharge from larger helicopters,
15
such as UH-60 Blackhawks, can be significant, and can cause a rescuer to lose balance, and potentially fall
from technical terrain.
There are two techniques that can discharge the static electricity to the ground without contact to the rescuer.
These include:
 The use of a Static Discharge Cable
 Enabling the cable to touch the ground before rescuers touch the cable
Static Discharge Cables are specialized metal cables, generally

about 3 meters long, that hang below a suspended rescuer to
provide a conduit to discharge static electricity before the rescuer
touches the ground. These cables are attached to the hoist hook
equipment ring and include a “weak link” that will fail and release
the cable if the cable somehow becomes entangled during an
operation.
Rescuers who do not employ static discharge cables should first

allow the hoist cable to touch the ground before grabbing it to
avoid receiving a shock. While this action may be counter-
intuitive - it is an important safety measure, particularly in dry
climates, or where there is dust or snow in the air.
Although the cable discharges its static electricity when it touches

Photo: CAPEWELL Aerial Systems
the ground, it is important to remember that the static will
recharge immediately once the cable lifts off the ground if the
helicopter remains in hover. Rescuers must be vigilant and recognize that the potential of a shock remains,
particularly with larger aircraft.
At the same time, rescuers must balance this risk against the dangers presented by a discharge cable or hoist
cable left unattended on the ground. A static discharge cable or rescue hook can become entangled in many
types of terrain, creating a hazard for the entire rescue operation. For this reason, a static discharge cable is
often connected with a low-strength breakaway connection, like with a zip tie or Velcro connection.
Equipment Unique to Hoist Operations

Certain equipment is unique to a hoist operation, and is detailed below.
Hoist Hardware and Cable

The hoist mechanisms themselves generally come in two forms:
 A fixed mounted hoist mechanism that extends outward above the wide door of the helicopter, and
 A pivoting hoist mechanism that swings out from inside the helicopter when in use.
With both installations, the hoist and its cable are arguably the most important link in the hoist rescue safety
chain, and careful cable management by the Hoist Operator is critical.
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Swivel at the End of the Rescue Hook

The end of the hoist cable usually includes a
swivel that spins freely, often built into an
integrated hook. This enables the hook to
spin, reducing the amount of torque
transferred to the cable. If the spin did
transfer to the cable, not only would it load the
cable with additional tension in the form of
torque, but the eventual release of this torque
could cause the cable to spin back in the
opposite direction, creating a dangerous
situation.
The swivel is an important safety element of

the cable system, and rescuers must take care
when grasping the cable to do so in a way that
does not inhibit the function of the swivel.
Particular care should be taken when holding
the cable above the swivel, as gripping the
cable here is more likely to impair the free movement of the swivel. There are times when it is appropriate to
grab the cable above the swivel (for example, when loose cable gathers on the ground). What is important is
that rescuers remain mindful of the swivel when manipulating the cable.
Hoist Training Facilities

Specialized helicopter rescue training companies and
many helicopter rescue programs that operate a hoist
program will have a training facility with a separate
hoist mechanism for live training in an environment
that does require flight. Often this equipment is a
training tower or a hoist mounted inside the hangar
(as pictured to the left in the Air Zermatt hangar),
enabling rescuers to train on techniques to prevent
and reduce spin, such as forward flight, rapid
transition through rotorwash, and the use of hand and
leg position during hoist. Some programs also employ
high-fidelity "virtual reality" equipment to conduct
hoist operator training. Such training, however, does
not provide ground rescuers with an opportunity to Photo: Eva Sophia Shimanski – Air Zermatt Training
Center
practice collaborative exercises with the hoist
operators.
Hoist Training Consultants

Effective hoist-equipped programs require significant training, which is now available from a number of
rescue consultants worldwide. These consultants offer high-quality, hands-on training, either at their own
facility or at the site of the rescue program.
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Equipment Unique to Short-Haul Operations

Certain equipment is unique to short-haul operations, and is detailed below.
Short-Haul Anchor System

To conduct short-haul operations, an aircraft must have a
specially-designed anchor system to which the short-haul line is
connected. In its Helicopter Short-Haul Operations Plan, the
U.S. National Park Service defines a short-haul anchor system
as “the points of attachment of the short-haul rope system to
the helicopter. This system will include both a primary and a
secondary anchor. The primary and secondary anchors must be
designed for pilot and/or spotter release in an emergency. The
load must be fully jettisonable, using two separate and
Photo: Eva Sophia Shimanski/Air Zermatt
independent actions for release.”
The pilot and/or a crewmember must have the ability

to jettison the line (cut the rope free from the system)
in the event of an entanglement or other problem
with the cargo beneath. Using a dual-hook
connecting system, the pilot or crewmember must
take two actions to jettison the load, but to be clear,
with a dual-hook connection, either the pilot or
crewmember can independently jettison the short-haul
line; but the independent action of that person
requires two steps.
Photo: National Park Service (from "An Introduction to
Short Haul Rescue" (LINK HERE)) (Note that the National Park Service developed a ten-
minute "Introduction to Short Haul Rescue" (LINK
HERE) that is valuable, and describes the primary and secondary releases well.
Rope for Short-Haul Systems

Unlike the cable used for hoist systems, short-haul
systems generally use a static rope to connect rescue
personnel and subjects to the helicopter anchor.
The ropes used in short-haul are often made of

dyneema and synthetic fibers, and can vary in length.
Program requirements, aircraft type and the specific
needs of the rescue at hand dictate the lengths of rope
used in a short-haul rescue operation. Air Zermatt, for
example, uses a 14 mm diameter rope that is
manufactured specifically for human external cargo.
That rope can hold as many as six people. Although that may seem like a lot of weight on a 14mm rope,
keep in mind that this rope was not designed to withstand the force of a dynamic fall or shock.
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As with ropes used by rescue teams during technical ground-based rescues and training, HEC programs
should document the date and use of each short-haul rope, and inspect them carefully for damage after each
use. Ropes should be retired when age, damage, or the end of predefined life-cycle compromises their
structural integrity and safety.
Rescue Rings
While the use of a rescue hook at the end of a short-haul line is
common in many short-haul systems, some use a ring spliced to
the end of the line in lieu of a hook.
Weight at the End of the Line

Short-haul operators will often attach a weight to the short-haul
line above the rescue ring/hook to reduce the ability of the line
to swing in an uncontrolled manner, to trail behind the aircraft
while in flight, or from acting as a pendulum when the aircraft Photo: Eva Sophia Shimanski/Air Zermatt
transitions to hover. Many rescue teams permanently mount a
weight ball roughly 2 meters above the rescue ring/hook. For short-haul fixed lines longer than 100 meters,
additional weight may be necessary, or rescuers may wish to have a human rescuer on the line.
The weight on a short-haul line can pose a danger to the unaware rescuer. As the helicopter delivers an
unattended short-haul line to rescuers on the ground, those rescuers need to be careful to not be hit by the
weight, which could injure them or knock them off their feet.
Equipment for Securing and Transporting Injured and Uninjured

Subjects
There are numerous unique pieces of equipment designed to transport injured and uninjured subjects from
rescue scenes. Often, it is the subject’s injuries (or lack thereof) that determine which device will be used.
These pieces of equipment are detailed by Ken Phillips in his “Helicopter Rescue Techniques” manual, which
may be found at THIS LINK.
Equipment for Transporting

Severely Injured Subjects
Rescue operators employ specialized equipment to
transport subjects with injuries that require spinal
cord protection, transport in the supine position,
or transport with splints and/or spinal restriction
protocols. These include:
 Helicopter Rescue Bags Photo: Charley Shimanski/Air Zermatt

 Medevac Litters
Key to these specialized rescue bags and litters is the ability to secure the patient in a way that not only
provides spinal cord protection, but reduces the possibility of patient movement in the litter while in flight.
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Equipment for Extricating Uninjured

Subjects
Equipment specifically designed for extricating uninjured
subjects and/or those who do not have injuries that necessitate
transport in a supine position include:
 Rescue Net (Billy Pugh Net)
 Collapsible Rescue Basket
 Rescue Seat or Forest Penetrator (Jungle Penetrator)
 Rescue Strop and Quick Strop
 Rescue Evacuation Triangle
Photo: Charley Shimansko with Bernalillo  Screamer Suit
County, New Mexico (USA)  Hoisting Vest
Again, these types of equipment are detailed in Ken Phillips’ “Helicopter Rescue Techniques” manual, which may
be found at THIS LINK.
Personal Equipment for Rescue Personnel (Part One)
Safety Harnesses for HEC Rescuers

Harnesses for HEC rescue personnel must be easy to use, with an
easy-to-identify connecting point. These harnesses must provide
suspension comfort, as rescuers could be suspended in a harness for
long periods of time. The rescuers’ flight program should approve
the harnesses authorized for their programs, and these harnesses
must conform to appropriate and applicable governmental,
international and society recommendations. Rescuers must inspect
their harnesses and associated connecting equipment regularly, and
retire equipment when it becomes compromised by age or damage. Photo: Eva Sophia Shimanski
Broadly considered, there are three different designs of rescuer harnesses: a lower-body only, a lower- and
upper-body combination, or a full-body “class III” harness. Each rescue program should evaluate the
advantages and disadvantages of each harness type against the specific demands and environment in which
the program operates.
The harness of a HEC rescue technician should be kept free of equipment unnecessary for HEC work to
reduce the risk of entanglement and the possible impairment of the rescuer's downward visibility. Most
harness connection systems use one carabiner that will be clipped into the short-haul or hoist system, ideally a
tri-action steel carabiner (as recommended by the International Commission for Alpine Rescue’s Air Rescue
Commission - LINK HERE), although some harnesses do not rely on a carabiner to make the connection to
the hook. Rather, the connection is made with a delta (“V") ring on a bridge (“lifting strap”) that cannot roll
off the hook. One or two carabiners clipped in the very back of the harness may give the rescuer the ability
to quickly connect to a ground anchor in technical terrain, or additional equipment or personnel during the
operation itself. To the extent possible, additional rescue equipment should be carefully stored in the
rescuer’s backpack and not on the harness. After the helicopter inserts the rescuer, the rescuer can then
unpack any needed rescue equipment and attach it to his or her harness.
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Many rescuers prefer a rescue harness that makes it difficult to inadvertently clip in to the wrong attachment
point. A harness like the Petzl Falcon, for example, has a shiny steel connecting point that makes it easy to
identify where the hook connects.
The key to any rescue harness is in its fit. It should sit above the hips with a snug fit around the waist and
through the leg loops. As long as a harness is appropriately secured to the body, it is unlikely that a rescuer
can fall out, even if inverted.
Seat harness or full-body harness

There are a few noteworthy differences between a lower-body
harness and a full-body harness. A full-body harness can limit
the ability to quickly add or remove clothing. These harnesses
may pose a problem for rescuers who must dress in layers, and
who need to doff and don jackets quickly to accommodate the
temperature change from rescue site to aircraft cabin to medical
facility. This is particularly true of rescue personnel working in
high altitude and austere environments. Photo: Charley Shimanski with Bernalillo
County, New Mexico (USA)
A lower-body harness provides a lower connection point than
do full-body harnesses, and many rescuers believe they hang on a HEC hook much better when the
connecting point is lower. When loaded with heavy backpacks, however, rescuers may find that a lower-body
harness suspends them with an awkward center-of-gravity. In these cases, a full body harness may be the best
option, or the rescuer can tether the pack to the cargo loop so that it hangs independently on the rescue
hook/ring. The website of Canada-based Boost Systems includes a number of harnesses and patient transfer
devices worth reviewing.
Safety Check of Harnesses

Whenever possible, rescuers should perform a pre-flight safety
check of each other's harnesses prior to every HEC operation.
This safety check is to ensure the harness is properly worn and
in condition suitable for use. Sometimes referred to as a “ten-
point check,” this review looks for:
 Any damage to the harness
 Adequate tightness of the leg loops
 Adequate tightness of the waist bands
 The condition of the harness connecting point
 The presence of any extraneous and unnecessary
equipment
Personnel Carrying Device Systems

(PCDS)
The term Personnel Carrying Device Systems (PCDS) is a
recent addition to both rotorcraft harnesses and the
regulations that govern them. PCDS are essentially the Photo: Eva Sophia Shimanski/Air Zermatt
harness/restraint systems that enable rescuers to attach a
rescue subject and/or themselves safely and effectively to the hoist or short-haul cable.
21
The European Union Aviation Safety Agency (EASA) defines a PCDS as “a device or system that has the
structural capability and features needed to transport occupants external to the rotorcraft during HEC
operations. A PCDS includes, but is not limited to, life safety harnesses (including if applicable quick release
and strop with connector ring), rigid baskets and cages that are either attached to a hoist or cargo hook or
mounted to the rotorcraft airframe.”
Simple or Complex PCDS

EASA classifies PCDS as “simple” or “complex.” In their Certification Memo, EASA gives the following
examples of simple design:
 A safety harness or rescue triangle for max. 2 individuals conforming to the harmonized EN-
Standard (Personal Protective Equipment (PPE) in accordance with a EN standard under EU
Directive 89/686/EEC, incl. mountaineering equipment (e.g., EN 361 for body Harnesses, EN 358
for restraint systems [straps], EN 362 for Karabiners/fasteners). The harness could be attached
directly to the hoist hook, or to the cargo hook via means of rope system.
 A fixed rope system to be attached under a single cargo hook or Y-rope to be attached to a dual
hook. The ropes must be certified according to an EN standard and be designed to transport
maximum 2 persons.
 Elements restraining a single hoist or cargo hook operator inside the cabin, when the ropes are
certified according to an EN standard.
EASA further provides examples of complex design, as follows:

 A cage which hosts one or more individuals
 A system connecting 3 persons or more to the cargo hook
Helmets
Flight helmets are specially-designed helmets normally
worn by pilots and HEMS crewmembers on board the
aircraft, and are an essential safety element for
crewmembers while in flight. The typical flight helmet
includes integrated, noise-canceling earphones and
microphone for intercom within the cabin and air-to-
ground communication.
While flight helmets facilitate communication on board,

they can impair communication in the field: it is hard to
hear ambient noise and conversation with a flight helmet
on. Moreover, flight helmets can limit a rescuer’s vertical Eva Sophia Shimanski
field of vision, and often include a mount for night
vision goggles, which can limit the field of vision further still. For this reason, HEC rescuer personnel that
operate in austere mountain environments generally do not wear flight helmets when undertaking extended
work outside the aircraft. Impaired hearing and sight also pose significant risks to rescuers operating near or
under the rotor disk of a running helicopter. (A visual field restriction was cited in a final report of a rescue
accident during which an experienced flight crewmember was killed by a main rotor strike to the head.)
Several manufacturers of climbing and rescue helmets have developed custom adaptations to attach
specialized communication equipment, such as microphones and earphones. Petzl, Kask, and Team Wendy
22
have each developed rescue helmets that are specially designed to accept communication systems, including
those available from 3M/Peltor. These helmets provide the safety and visual field of a rescue helmet and are
equipped with specialized noise-reducing earpieces and microphones that enable the wearer to communicate
while onboard the helicopter, but can pivot off when outside the aircraft. Despite these adaptations, rescue
helmets lack the protective features of a true flight helmet and so should be used sparingly in the flight
environment. There is no ideal solution for helicopter SAR personnel and so the choice of flight helmet vs.
rescue helmet should be based on where the rescue personnel spend the majority of their time. If rescue
personnel work predominantly in and around the helicopter, then a standard flight helmet is the better choice.
If, on the other hand, rescuers spend the majority of their time on the ground, then a rescue-type helmet is
preferred.
Specialized Helmet-Mounted Equipment for Ground-to-Air Communications

Simple handheld radios are impractical for ground-to-air radio communication during an HEC operation.
These radios typically require the use of hands, and their audio quality is often compromised by the noise of
the helicopter. To circumvent these limitations, many rescue helmets are built to accept helmet-mounted
headsets with a pivoting microphone, noise cancellation and push-to-talk (PTT) controls. Most of the
3M/Peltor headset/microphone combinations are built with a conventional aviation plug (U-174, also known
as the NATO Plug) so that the operator can plug into the aircraft intercom system (ICS) while in flight.
These units can be fitted with a specialized adapter that enables that male U-174 plug, used with the
helicopter’s ICS, to also work with the user’s handheld radio as well. This gives the rescuer the ability to
quickly transition from the helicopter’s ICS to radio upon exiting the aircraft.
The ideal helmet-mounted headset includes a simple “push-to-talk” (PTT) switch. Many agencies utilize one
that can be operated in the rescuers hand so that the rescuer does not require a free hand to activate the PTT
microphone. The ability to engage a PTT switch while using hands for signaling or while retaining grasp of
equipment improves the safety and efficiency of the rescuer’s work. Others mount a switch directly to one of
the earpieces, making operation relatively simple, and removing the possibility of a hand-held PTT switch
being dislodged from the hand at an inopportune time.
Communication manufacturers have developed wireless and Bluetooth systems to enable wireless
communication within a helicopter’s intercom both inside and around the airframe. Some wireless intercom
models have been troubled by interference with aircraft’s many electronics systems, but future models
anticipate improved clarity and reliability.
Other Personal Protective Equipment (PPE)

Rescue personnel must be certain to have and employ personal protective equipment (PPE) to protect
themselves from the hazards of working in and near helicopters. Specialized eye, ear, and hand protection is
key, as is appropriate footwear and outerwear.
All rescue personnel should strongly consider the following PPE:

 Protective helmet.
 Ear protection, often in the form of disposable aviation ear plugs.
 Shatterproof sunglasses, safety glasses, or goggles.
 Fire resistant or leather gloves.
 Quality boots that are suitable for the austere and extreme environments in which the rescuers
operate.
 Knee pads for work in rocky terrain and on the floor of the aircraft.
23
 Specialized equipment, as necessary, including:

 Avalanche rescue equipment, including a personal transceiver, shovel, probe, and avalanche
airbag.
 Life vests or specialized survival equipment for over-water flight operations
 Lighting for night operations, including headlamps, Cyalume glow sticks, etc.
In mountain environments, helicopter rescue crewmembers are often inserted into austere environments and
may find themselves in situations where the aircraft is unable to retrieve them. In these cases, footwear,
outerwear, and additional gear should be suitably robust to enable long travel over ground through harsh
weather conditions and difficult terrain. When the helicopter cannot retrieve rescuers, rescuers must be able
to walk out or endure a prolonged wait.
Carabiners for HEC Rescuers

Carabiners are the most important specialized equipment that HEC rescuers must carry and use to connect to
a HEC system.
Carabiner Types
Most agencies operating HEC programs employ steel carabiners,
and of these, the use of tri-action carabiners is strongly
encouraged (as recommended by the International Commission
for Alpine Rescue’s Air Rescue Commission - LINK HERE).
Many rescue operators have discontinued use of aluminum
carabiners after their use contributed to several incidents and near-
misses.
Steel Carabiners
Steel carabiners are among the toughest pieces of equipment on
the helicopter. Many believe that other components of a rescue
system will fail before a steel carabiner does.
Tri-Action vs. Double-Action Carabiners

The tri-action carabiner requires three steps to open:
1. Disengage the locking mechanism
2. Twist the locking mechanism to the unlock position
3. Pivot open the carabiner
Oxan high-strength oval carabiner from Petzl
A double-action carabiner requires two steps to open:
1. Twist the locking mechanism to the unlock position
2. Pivot open the carabiner
Double-locking carabiners are easier to open, but that ease comes at the cost of safety: vibrations and
inadvertent rubbing against the carabiner can unlock the sleeve.
Screw carabiners are the quintessential carabiner locking system. While versatile and universal, their use has
its own pros and cons. A strength of these carabiners is that once closed and locked, they generally remain
closed - although vibration has been known to open the screw when placed in the wrong orientation. The
24
downside of these carabiners is that the operator must remember to close and lock them, and that, in winter
conditions, the screw can freeze.
As with all other rescue equipment, carabiners should be inspected regularly to ensure their gates open and
close and that the locking components function. Carabiners should be maintained according to manufacturer
suggestions (e.g., wash with soapy warm water, lubricate the spring, etc.).
25
3
Part
Part 3 – Principles of Flight
Short-haul operation Hoist Operation

Photo: Rocky Mountain House SAR, Canada Photo: Air Zermatt
When to Use Hoist vs. Short-Haul

The needs of each helicopter rescue program are unique, and each program must determine which HEC
model best meets these needs, whether hoist, short-haul, or both. The choice to run hoist or short-haul
operations is an important one, and should be made only by HEC program managers, with their rich
understanding of a program’s history and operational needs. Some countries’ programs use both short-haul
and hoist, while others use only short-haul (Austria, Norway, Sweden), and others use largely hoists (France).
26
Hazards of HEC Operations

HEC operations can succeed where
conventional helicopter rescue is impossible,
but the added power and versatility of HEC
operations come always at the cost of
increased risk. Two technical challenges
underpin these risks, and are:
 The pilot must hold the
helicopter in a hover, and during
the most critical parts of an
operation, must often do so
while making high power
demands from the engine.
Ken Phillips, Helicopter Rescue Techniques - NSARA Manual
The aircraft will often need to hover within
300 feet off the ground, with little to no
forward airspeed. This position renders safe
autorotation challenging should engine failure occur. Rescue operators should consider aircraft performance,
aircraft weight, terrain, and environmental factors to mitigate this risk.
Constrained by these technical challenges, HEC operations provide little or no margin for error.
Nonetheless, there are times when hoist and short-haul provide the only way to save a life. (For a further
exploration of the benefits of HEC operations, see lesson one.)
Execution of a Hoist Operation
The Role of the Hoist Operator

If the pilot is the most important crewmember during a HEC
operation, the Hoist Operator is a close second. While the
pilot is responsible for the operation and performance of the
helicopter, the Hoist Operator is responsible for:
 The technical and safety components of the hoist
cable, to include preventing the shock-loading of
and damage to the cable.
 Control of the hook: raising and lowering and
pivoting it into the aircraft.
 Close coordination with the pilot to ensure proper
hook placement at chosen target site.
 Directing the efforts of rescue crewmembers
Successful deployment of the cable requires careful,

choreographed interaction between hoist operator and pilot.
This collaborative positioning of the aircraft, referred to as
conning of the aircraft, requires experience and training. The Photo: Air Zermatt/Vertical Magazine
hoist operator manages a handheld hoist control unit that
enables him or her to safely and easily pay out or retract the
27
cable, while the pilot positions the aircraft. In many aircraft, the pilot has redundant hoist controls on the
collective.
Hoist operators work at the door of the aircraft, often standing on a skid. To perform this task safely, the
hoist operator must be secured to a safety tether in the open doorway of the helicopter. Hoist operators
frequently wear long tethers to enable them to reach to operate the hoist, to spot for the pilot, or to move
about the cabin. Having a reliable, one-hand-adjustable tether (like the Petzl Grillon) can prevent the hoist
operator from falling out of the aircraft when working in the cabin, but can be easily adjusted to allow for
harnessed work outside the aircraft on the skid when
necessary.
Safety with the Hoist Cable

While the primary responsibility of the hoist operator is the
safe raising and lowering of human external cargo, he or she
must also protect the integrity of the hoist cable itself. The
cable can encounter varied forms of mechanical error or
failure while reeling in and out of the hoist mechanism, and
the hoist operator must guard against them with vigilance.
In particular, the hoist operator must keep the cable free Photo: Oliver Kreuzer/Air Zermatt
from the exterior of the helicopter (especially the skid) to
prevent abrasion of the cable and aircraft. With few exceptions, the cable should only be unreeled and
retracted while the cable is not touching the skid. (As an additional measure of protection, some helicopters
have a strip of High-Density PolyEthylene, or HDPE, installed along the outward edge to protect against
cable abrasion.)
When a hoist load begins to swing, it can become a pendulum that can cause repeated, successive damage to
the hoist cable as it rocks back and forth against the skids. To correct this dangerous movement, the hoist
operator will reel out the cable to greater length. Forward flight can also reduce the pendulum swing of a
hoist cable.
Rescuers Secured to the Inside of the Aircraft

SAR members are occasionally involved in insertion and extraction operations with open doors, and
sometimes the aircraft is configured without seats to save weight. In these cases, the rescuers must sit on the
floor and tether themselves and their gear to a suitable anchor point within arm’s reach. Specialized
equipment (such as the Petzl Progress-Adjust lanyard combined with a Petzl AM’D twist-lock carabiner or
the Eashook Open connector) provides easy, one-handed attachment and adjustment to help SAR personnel
get themselves and their equipment quickly and safely secured for flight.
Once on Scene of a Rescue Incident

A HEC rescue helicopter may be called to a backcountry scene that ground rescuers have yet to reach. When
this occurs, the pilot and aircrew first perform an airborne reconnaissance and scene assessment before
attempting any rescue. Once rescuers locate the subject in need of aid, the pilot and crew will assess hazards
in the area. These could include:
 Technical terrain that adds risk to rescuers when they are inserted.
 Danger posed to persons on the ground from rockfall caused by rotor wash.
 Danger of avalanche and other natural hazards for rescuers who are to be inserted.
 Other civilians at the scene.
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Picking up Rescuers and/or Subjects by Hoist

The delivery of the hoist hook to rescue personnel on the ground must be a well-rehearsed and well-
coordinated effort by the pilot and hoist operator. In general, the hoist operator will adjust the vertical depth
of the line while giving directional/conning commands to the pilot. These conning commands are direct,
clear and usually limited to the horizontal plane (e.g., “forward 10,” or “left two,” or “right five,” etc.).
Successful delivery of the rescue hook to rescuers on the ground can resemble the threading of a needle.
When 60 to 90 meters of cable are reeled out, precise movement of the hoist hook becomes difficult.
Communication between pilot and hoist operator is not merely essential to place a rescue hook in the right
horizontal and vertical planes, it is also essential to ensure the timing of hook delivery to ground rescuers is
perfect. An intercom exchange between the hoist operator and pilot might sound something like this
 “Forward 20” (indicating 20 feet forward to reach the ground rescuer)

 “Right three” (indicating drift the aircraft right three feet)
 “Forward ten” (indicating ten feet forward to reach the ground rescuer)
 “Three, two, one” (indicating a countdown in seconds for the rescuer to receive the hook)
 “Hold position” (indicating hold forward flight and any movement left or tight)
 “Rescuer has the hook” (indicating the rescue has the rescue hook in hand (and is presumably
attaching)
 “Hooked in” (indicating the hand signal has been received from ground rescuers that the load has
been clipped to the rescue hook)
 “You take the load” (indicating that the pilot can lift the load using the collective and perform a
power check)
 In some programs, the pilot picks up the load, in others the Hoist Operator does. This
depends on the experience of the program.
 “Load up off the ground” (indicating that the aircraft now is carrying the entire weight of the load).
There can be a momentary pause here where the rescuer performs a final cross/safety check.
 “Clear for forward flight” (indicating that the helicopter is clear for forward flight)
There is variability in how hoist operators communicate. In many programs, these commands are NOT a
measurement of distance. They are simply a countdown of space and a means to track movement by verbal
cadence until a target is reached. The result is the same but the method eliminates the difference in people’s
estimation of distance.
At the same time, if the load includes a rescuer who is able to communicate with the aircrew by radio, that
rescue crewmember may also signal that the load has left the ground. It is essential that this rescuer also
communicate if the load is blocked by or free of obstacles in the horizontal plane. In the absence of radio, the
suspended rescuer can communicate clear passage to the aircrew by a specific hand signal.
If the rescue cable is not delivered with precision to rescuers on the ground, or if the hoist hook is swinging
in a pendulum motion, the best corrective action may be for the pilot and hoist operator to exit the scene and
return for a second try. This is particularly true for hypothermic casualties or those at risk of becoming so,
because the longer the aircrew attempts to correct a misplaced hook, the longer the helicopter downwash
rapidly cools those beneath it. Extended hover time is not only a hazard for the hypothermic - it can pose a
danger to the helicopter and its crew. Although capable of hover, helicopters operate more safely in forward
flight.
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Whenever an incoming helicopter is about to deliver a rescue

hook, rescuers on the ground should assign a single member,
the rescue leader, to take the rescue hook. The rescue leader
should position him or herself and make ready to grab the
hook, taking static discharge into account (as detailed earlier in
this training).
Because the helicopter may descend from above or ascend

from below, the rescue leader should be prepared to use hand
Photo: Air Zermatt
signals to guide the pilot to climb or descend to

deliver the hook at the proper altitude. On near-
vertical technical terrain, a rescuer on the wall
should be the one directing the height of the hook
relative to the rescuers but NOT its horizontal
movement. The Hoist Operator can see whether
the hoist hook needs to move left or right as the
aircraft is approaching the rescuers, and can notify
the pilot accordingly.
Execution of a Short-Haul Operation
Attaching the Rope to the Short-Haul Anchor

In short-haul operations, rescuers must attach the short-haul
system to the bottom of the helicopter, often while the rotors
are turning. Preparation of the short-haul system in advance of
the helicopter’s arrival is key to ensure the safe execution of
these operations, although ideally the short-haul rope itself
should be deployed following arrival of the helicopter.
Photo: Oliver Kreuzer/Air Zermatt,
Connecting the short-haul anchor system requires practice.
Consider, for example, when a short-haul connection must be
made in winter in the field, and the aircraft has sunk into a snowy landing zone. In this difficult scenario, the
rescuers may have to dig their way to the connecting points to attach the line to the helicopter’s short-haul
anchor, or undertake the connection while the helicopter hovers close to ground.
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Connecting Multiple Rescuers to the

Rescue Hook
Many programs employ connecting mechanisms that
enable multiple rescuers to be short-hauled into and out of
a scene at one time. With these mechanisms, the rescuers
are all attached to individual components that are part of
one piece of connecting equipment. One lead rescuer is
assigned to attach that rescue component by carabiner to
the short-haul rescue ring, which should be done quickly
when the helicopter arrives to pick up the personnel.
Once rescuers are attached by carabiner to this multi-

rescuer connecting device, they must remain attached to
that device while it is connected to the short-haul rescue
ring. Once brought back to the ground, the pre-assigned
lead rescuer detaches the connecting device from the
rescue hook. The lead rescuer who is “clipping out” from
the rescue ring is responsible for the safety of the area and Photo: Eva Sophia Shimanski/Air Zermatt
the whole team. In general, rescuers should not detach Trqining Center
from the connecting device until the aircraft has departed
(and the rescuers are either secured to a ground anchor or certain that such anchoring is unnecessary).
While the ability to lift multiple rescuers on a single short-haul line is a useful one, the interconnection of
rescuers on a single line can pose a risk to the entire team. On cliffs and other complicated technical terrain,
the rescuers might become so focused upon the incoming ring that they do not pay attention to their
precarious position on the ground. In this setting, the interconnection of all rescuers can increase the
consequences of a fall. One rescuer’s slip and fall can cause the fall of the entire team. When the hook
approaches, rescuers must be careful not to “chase” it - to focus on the ring and forget the terrain - and so
invite peril to the entire operation.
Picking up Rescuers Already on a Connecting

Device
There are a few key safety considerations for situations
where rescuers, attached by a connecting device, are to
be lifted from the ground by a helicopter that has
landed to connect the short-haul line.
 When the pilot takes off, she or he should
perform a very quick power check, which gives
rescuers on the line a chance to look at the
system and confirm all is OK. If a power
check is not done, ground-to-air radio
communication is essential to enable rescuers to inform the pilot of a problem while the human
cargo is still on the ground.
 Each rescuer must make sure his or her connecting carabiner is not cross-loaded as the helicopter
begins to take up the load. This can usually be accomplished by having one rescuer hold the
connecting device overhead.
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 Rescuers must watch out for the weight ball as the pilot takes off, as this can be lifted off the ground
and swing into rescuers.
 Once the pilot takes the weight of the rescuers at the end of the short-haul line, he or she may lift the
load only slightly to perform a power check. If the power is marginal, the pilot may gently lower the
load and tell the rescue group to reduce the number of rescuers on the line. It is important to
recognize that the power check will normally be static, which may cause the load (in this case, the
suspended rescuers) to gently spin.
Dropping off Rescuers - Scene Safety

In steep and technical terrain, a rescue helicopter pilot will
often approach from below, which gives him or her the ability
to get an assessment of the rescue scene and any hazards in the
area. These hazards could include terrain issues for the rescuer
to be inserted, or entanglement hazards for the rescue system.
Still, the rescuers on the line are often better positioned to
assess the terrain as they descend.
When rescuers are to be dropped off by short-haul on a connecting device, the pilot may position the
rescuers just above the ground where he or she wishes to have the rescuers eventually unload. Because the
pilot cannot reliably evaluate the terrain of the proposed drop site, it is incumbent of rescuers to check the
site before completing the drop off. If rescuers find themselves being lowered to unsafe ground, they should
not unclip from the short-haul, but instead communicate to the pilot by radio or hand signal that the
proposed drop zone is unsafe.
Considerations in Safe Terrain vs. Steep and Technical Terrain

If rescuers are to be inserted by short-haul into safe and benign terrain, there remain several actions to
consider:
 The lead rescuer should detach the connecting device from the rescue hook as soon as the rescuers
reach the ground.
 Once the main line is free, the lead rescuer should extend an arm out with the line and its hook, and
release it immediately. If the rescue ring is held as the helicopter pulls away, the line can swing when
released, posing a danger to ground crew (from the swinging weight ball) and the aircraft (from
entanglement of the line).
If rescuers expect to be inserted by short-haul into steep and technical terrain, there are other actions to
consider:
 In such steep and technical terrain, there is more exposure time while the rescuer(s) commits to the
mountain and attempts to safely anchor him- or herself to the slope. Attention to this anchoring is
key. There have been numerous accidents where rescuers inserted by helicopter were injured or
killed from falls from technical terrain after their insertion.
 Rescuers should be prepared to clip into any available fixed anchor or have a camming device ready
to anchor themselves. In general, rescuers should not anchor into the terrain before they have
completely disconnected from the helicopter, unless they train for this high-risk transition often. For
these types of rescues, there are both simple and complex systems for the complicated load transfer
from the ground to the helicopter (as is described in In Lesson 5, Special Considerations). One example
32
is the Petzl “Lezard,” designed specifically for this purpose. The Munter/Italian hitch or simple
cutaway are other methods.
 If the area is rocky with cracks or gaps between rocks, rescuers must be careful not to let their feet
become stuck between rocks while still connected to the short-haul system. Wind or other factors
may prompt the pilot to reposition the aircraft, which can cause the rescuer to be caught or injured
when the line moves but he or she cannot.
Radio Communication for HEC

Operations
Radio communication and coordination between helicopter
rescuers on the ground and their pilot and aircrew are vital, but
it must be precise and disciplined. Ground rescuers should
limit ground-to-air radio communications to the essential.
Unnecessary communication can reduce the situational
awareness of pilots and aircrew, and introduce danger during
complex operations. Air Zermatt rescue crew from The Horn,
courtesy Red Bull Media
Onboard, rescuers should keep intercom radio communication
to a minimum. Many rescue helicopter pilots may not want a rescuer to speak on the radio much at all. The
preparation and execution of complex HEC operations is no time for unnecessary chatter. A general rule is
“speak only when you see an in-flight hazard” and operate a “sterile cockpit” when complex operations are
underway. A sterile cockpit is one in which no one engages in conversation on the aircraft intercom radio, and
uses the radio for mission-specific communication only. HEC crews will often keep a sterile cockpit during
departures, arrivals and key operational moments, relaxing the rule only once a safe altitude is reached. The
sterile cockpit enables the crew to focus on mission-critical activity without distraction.
If radio communication is lost completely during a HEC operation, rescuers can transition to the use of hand
signals and the operation may continue at the discretion of the pilot and crew. The loss of radio
communication may not require terminating the operation if this adverse situation is anticipated, and a second
means of communication (e.g., hand signaling) has been created and practiced by the team.
Hand Signals for External Loads

The use of hand signals in HEC operations is more important
than their use in simple landing and take-off procedures at
helispots because of the increased complexity and risk
associated with HEC operations. This is especially true if radio
communications between ground rescuers and crewmembers
on the aircraft are lost. For all their usefulness, however, hand
signals are limited by sight: they become difficult to interpret at
night and with very long short-haul lines.
Even when ground rescuers have radio contact with the

Rescuer waving hand horizontally to indicate
aircrew, the team may prefer to have those on the ground "hold hover/leve.l" Photo: Oliver Kreuzer/Air
communicate via hand signal. If the pilot and aircrew are Zermatt
communicating by intercom, the ground rescuers can signal
33
without inadvertently introducing cacophony into the cabin while the hoist operator and pilot are
coordinating their work.
Specific Hand Signals for HEC Operations

There are several hand signals that are particularly valuable
for HEC rescue operations. These include the following:
 COME UP – Swing the right arm clockwise above the
head in wide and exaggerated circles indicating
“increase altitude.”
 COME DOWN – Swing the right arm clockwise
below the waist in wide and exaggerated circles
indicating “decrease altitude.”
 HOLD HOVER (LEVEL) – A horizontal wave of
the hand (perhaps as many as three times), to
indicate to hold present altitude. This signal is used
to indicate that the rescue hook is at the appropriate
height as it approaches rescuers, or by a rescuer on
the rescue hook to indicate that he or she is at the
appropriate altitude for a drop-off. Rescuer waving both arms horizontally to
 CLEAR OF OBSTACLES – An arm pointing in the indicate "clear of obstacles/tree canopy."
direction of travel, indicating the rescue load is above Photo: Charley Shimanski with Bernalillo
all obstacles on the horizontal plane. County Sheriff's Office, New Mexico (USA)
 WAVE OFF – A swinging of both arms over the
head, back and forth, indicating “Do Not Land” and “abort.”
Operational Considerations for HEC Operations
Transferring the Load from the Ground to the Helicopter

There are two ways to transfer load from the ground onto the helicopter’s HEC cable. The first method is
when the pilot lifts the aircraft to take the load. The second is when the hoist operator takes the load by
retracting the hoist line.
Pilot Taking the Transfer of the Load

In some programs, the pilot leads the transfer of the load from the ground to the helicopter. In this case,
when the pilot and crew are ready to take the load, the pilot lifts the load with the aircraft using the collective,
and checks to determine that there is sufficient power to fly with the additional weight. If there is not
sufficient power, the pilot can lower the collective and bring the load back to the ground safely, as long as the
terrain and situation allow.
Veteran HEC and HEMS helicopter program director Casey Ping notes that there may be some cases where
bringing the load back to the ground is not feasible, including near-vertical rock walls, areas of dense trees,
etc. In these cases, once the pilot takes the load, he or she is committed to the load. This point-of-no-return
should be anticipated and discussed prior to the operation. As Casey notes, “In most cases we already inserted the
rescuer. We should be assessing power during the insertion. We are probably burning fuel before extraction. If we don't believe we
have power we should be doing something about that before commencing extraction.”
34
A load transfer that begins with the pilot taking the load may be preferable to those transfers where the hoist
operator takes the load. When the hoist operator initiates the transfer, the pilot may not know with certainty
when the load is off the ground, and absent that certainty, it is difficult for the pilot to know how much
power is available with the new added weight. If the pilot transfers the load, it is easier for her or him to
determine if there is sufficient power, and if so, the pilot can tell the hoist operator to begin to reel in the
load. Once that load is clear of obstacles (which may be immediately), the pilot can transition into forward
flight and the hoist operator can continue hoisting the load up to the helicopter.
When the load transfer occurs in an area with wires, cables,

very tall trees or other obstacles above ground level, the
pilot can continue to lift the load with the collective (by
gaining altitude) without forward flight. Doing so allows
the helicopter and its suspended load to clear the obstacles
without retracting the hoist line and could bring the load
inside the “danger zone” of 1.5 times the rotor diameter
below the helicopter. In this danger zone, the rotor
downwash can cause the load to spin, possibly into the
nearby obstacles. Once the load is above any obstacles
(indicated by a hand signal or radio call from the rescuer on
the line), the pilot can transition into forward flight, and the
hoist operator can then safely reel in the load at a normal
rate.
Additional loading of the helicopter often requires more

power from the engine if the helicopter is to stay aloft;
increasing engine power increases rotor downwash. The
hoist operator should avoid raising a load into that
downward rotor flow. By waiting until the helicopter is Photo: California Highway Patrol Air Operations
forward flight and the rotorwash is behind the load, the
hoist operator can more safely raise the load.
Hoist Operator Taking the Transfer of the Load

In the majority of hoist operations, the pilot cannot see the load and the hoist operator has the best picture of
the operation, and is thus in a better position to take the load. Other instances when the hoist operator might
take the load include:
 Terrain that would prohibit returning the load to the ground once transferred to the helicopter.
 When helicopter power/performance is not in question (power check completed prior to initiating
the extrication).
35
Providing Critical Medical Care during HEC

Transport
Performing invasive medical procedures during HEC transport
is difficult, if not impossible. Forward airspeed will create a
windy environment for patient care in short-haul rescues, a
challenge exacerbated by the position of the rescuer relative to
the patient. As an example, CPR during HEC transport is
impossible without a mechanical CPR device. To continue
adequate medical care, it is key that the rescue team transfer the
patient quickly from the HEC line to a qualified HEMS aircraft. Bild am Sonntag Magazine/Christian Spreitz
Pain management prior to a technical external cargo helicopter
operation should be considered. At the same time, the HEC litter attendant should be aware that motion
sickness, anxiety, litter spin and the movement of the rotor overhead can cause rescue subjects to vomit and
potentially aspirate during a HEC operation. For this reason, pretreatment of nausea should also be
considered.
Transition of a Patient from the Hoist/Short-Haul to a HEMS Aircraft

There are a number of methods used to transfer a patient from a hoist or short-haul operation to the inside
of a HEMS helicopter. Efficient patient transfer from line to cabin is essential to continue medical care. The
proper method depends on the rescue helicopter used to retrieve and transport the injured subject, and the
HEMS helicopter available to provide critical care.
For example:
 If the rescue helicopter is not HEMS-capable, and a suitable helispot is available that can
accommodate two helicopters, a “Nose to Nose” transfer operation may be the method of choice.
In this case, a HEMS aircraft can be pre-positioned at the designated helispot, and the crewmembers
of both aircraft can transfer the patient from the rescue helicopter to the HEMS aircraft.
 If the rescue helicopter is not HEMS-capable and the subject is rescued using a short-haul, the rescue
helicopter crew may choose to transport the subject and rescue litter attendant by short-haul to the
location of the HEMS helicopter. In this case, the HEMS helicopter must be at full stop, with rotors
not turning, when the HEC aircraft arrives. The HEMS helicopter crewmembers must be ready to
transfer the patient to their aircraft once the HEC load is safely on the ground.
In addition, some HEMS helicopters with hoist capability are not able to transfer the patient from the end of
the hoist line to be fully inside the aircraft while in flight. These programs often hoist the patient and rescuer
to the skid, then land to safely transfer the patient onboard.
36
4
Part
Part 4 – Helicopter Management and Safety

Precautions
In this lesson, we explore operational considerations related to all HEC rescues as well as advanced helicopter
rescue elements that are independent of HEC operations.
Helicopter Service Ceiling, Hover and Flight

All helicopters have a service ceiling. A helicopter’s service ceiling is the height above sea level at which the
helicopter can no longer climb at a rate of 100 feet per minute. A helicopter rated to fly at a certain altitude
cannot hold a hover at the same altitude, because the power demands of hover are greater than those for
forward flight.
The transverse flow effect is a major contributor to the

helicopter’s ability to fly at altitudes higher than it can
hover. This effect describes the behaviour of the
helicopter’s rotor system in response to the airflow
generated by forward flight. A full discussion of the
effect is beyond the scope of this text, (interested parties
are referred to FAA-H-8083-21A – Helicopter Flying
Handbook chapter 2), but a simplification is that hover
requires the use of air recirculated through the rotor
blades, which creates less efficient lift than does forward
flight. Forward flight also tends to stabilize the
helicopter’s torque, and so requires less use of the tail
rotor. With less engine power directed to the tail, more is
available for the main rotor to generate lift. In other Image by: DynamicFlight.com
words, a helicopter certified to fly at 23,000 feet is very
unlikely to be able to hover at 23,000 feet.
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To determine whether a helicopter has sufficient

power to perform a rescue operation, the pilot
and/or crewmembers must assess a number of
related variables, including temperature, humidity,
density altitude, weight of the aircraft and its payload,
wind direction, and wind speed at the time of the
operation. Precise load calculations for the
conditions of each flight are critical, and
miscalculation of helicopter power can have
catastrophic results. The importance of this flight-
and-mission-planning calculation cannot be
overstated, and many fatal helicopter rescue accidents
have occurred due to incorrect or inadequate load
calculations. Further information on load
calculations can be found on Page 29 of “Helicopter
Rescue Techniques.”
Amount of Fuel on Board at the Start of

an Operation
When flying rescue operations at altitudes that might
challenge an aircraft’s performance, one strategy is to
fly with the least possible fuel to reduce weight. The
more fuel on board, the more fuel the pilot may have
to burn off to achieve the required performance to
execute the operation at the required altitude.
USFS Load Calculation Worksheet example That said, underestimating the fuel requirements of a
rescue operation can result in serious complications.
Needing to leave a rescue scene to refuel may add delays, and if the helicopter fuel level drops below the final
reserve, the pilot would normally have to declare an emergency and land, seriously disrupting the rescue
operation.
Aerodynamics of Human External Cargo

While attaching HEC below a helicopter seems straightforward, the interplay of HEC and flight is not as
intuitive. Even if a helicopter has more than sufficient available power to lift an external load, the presence of
HEC in flight brings other challenges, to include:
1. Wind vortices beneath the helicopter caused by the rotor downwash.
2. Obstacles that increase the risk of entanglement.
3. The heightened situational awareness HEC operations demand and the increased cognitive workload
on pilot and aircrew required to sustain that awareness.
38
While in hover, the greatest impact of the rotor downwash occurs

at a distance between 1 and 1.5 times the rotor diameter, where the
vortices created by the rotor downwash are at their greatest. For a
helicopter with a rotor diameter of 12 meters, the downwash would
be greatest between 12 meters and 18 meters beneath the main
rotor. When an external load is suspended in that range 12 to 18
meter range, it has a greater risk of spinning.
Hoist Operations and Downwash

It is important that HEC rescue personnel understand that the
vortices created by a helicopter’s rotor downwash can affect the
movement of an external load.
Hoist Operations, Spin and Oscillation

The impact of rotor downwash on the suspended load is the
primary driver of load spin. A litter and any rescue attendants will
generally not spin while in forward flight greater than the
helicopter’s effective translational lift (ETL), which is often
between 16-24 knots. In forward flight greater than ETL, the rotor Graphic: Charley Shimanski/Air Zermatt
downwash is forced behind the external load, and therefore has no
impact on the load. Furthermore, forward flight creates a wind equal to the helicopter’s airspeed minus the
tailwind, if any. This wind also acts to reduce spin. Rescuers on the line can take small physical actions to
counteract a modest spin, for example, by simply holding one arm and hand out. These maneuvers to
counter spin should be practiced during training.
Keep in mind that 20 knots of wind off the nose of the

helicopter essentially produces the same effect as ETL. Rescuer
Casey Ping notes, “During training we induce litter spin and show how
it occurs, how air speed can mitigate it. The Hoist Operator can, when
possible, pay out hoist cable which can also move the load out of the rotor
downwash vertically. In some cases, we have been unable to intentionally
cause a litter to spin because of wind at the training site.”
Main rotor downwash will have an impact on an external load

when the load is directly below the helicopter and the
helicopter is not in forward flight. This generally occurs when
the helicopter first takes up the load and when it approaches
the area where it will drop off the load. The time spent in this
situation can be minimized, however, if the rescue load is ready
for pickup prior to the arrival of the helicopter and the
helicopter pilot is prepared to perform a dynamic hoist
extraction – one where the helicopter, cable, and rescue hook
must only be stationary for the brief moment during which
rescuers are attaching the external load to the hoist hook.
Graphic: Charley Shimanski/Air Zermatt
“Oscillation” of the load is another aspect of low-speed (near-
static) operations that can be dangerous. Oscillation is the rapid movement fore and aft of a load, and can
occur when an external load transitions in and out of the rotor downwash while it is pulled only slightly behind
39
the aircraft due to a slow fly-away speed (below the helicopter’s ETL or in winds less than 16 knots). A pilot
increasing forward airspeed to greater than ETL will generally overcome this situation.
If the load begins to spin excessively during the final approach to deliver it, the pilot can consider aborting
the attempt, and circling around to come back in under a greater airspeed.
Static Hoists vs. Dynamic Hoists

It is important to distinguish between static and dynamic hoists, because these two hoisting maneuvers carry
their own advantages and liabilities.
Static Hoist
In a static hoist maneuver, the helicopter remains stationary
in a hover above the rescue scene while the load is hoisted
onboard. This technique, most frequently performed with
larger helicopters, brings the load into the rotor downwash,
which is likely to cause the load to spin, particularly if that
load includes a human subject in a litter. To counter this
spin, rescue teams have employed anti-rotation rudders
operated by a rescue litter attendant
Anti Rotation Rudder by TYROMONT
Other teams
have incorporated “tag lines” operated by rescuers on the ground.
While taglines can be an effective means to prevent spin, they
introduce their own problems, which include:
● The aircraft MUST remain stationary, and therefore at full
power.
● An extra rescuer, trained in the operation of tag lines, is
required on the ground.
● The hoist operator has an added responsibility when the
load reaches the aircraft, namely to disconnect and drop the tag
Photo: AirMed&Rescue Magazine line.
● A tagline will not prevent spinning if the helicopter
remains directly overhead. Once the connection is made, the helicopter must “offset” to the side so
the tag line guides the load outwards as it is hoisted upwards.
● The tag line rescuer should not hold too tight and just before the load reaches the helicopter the
rescuer should relax their hold on the line, so the hoist operator can detach the tag line.
Dynamic Hoist
An effective alternative to the static hoist is the dynamic hoist, a technique that reduces the likelihood that an
external load will spin, and eliminates the need for tag lines. In a dynamic hoist, the pilot moves the helicopter
into forward flight as soon as is safely possible once the load is taken. Similarly, a rescuer inserted in a
dynamic hoist operation is lowered by the hoist operator while the aircraft is in forward flight and on final
approach to the rescue scene – enabling the rescuer to safely reach the ground just as the helicopter
approaches the scene.
40
When the ground rescue team is ready for hoist extraction and the
HEC rescuer is ready to be picked up, the helicopter returns, again
in forward flight, and delivers the hoist hook directly to the rescuer
just as it arrives over the rescue scene. For a dynamic hoist
extraction to be successful, the crew should prepare on site for the
retrieval well before the aircraft arrives directly above the scene.
The hoist operator will unreel the cable while the helicopter is in
forward flight and moving into position, and will try to extend the
cable so that it reaches the rescuers just as the helicopter
approaches overhead. Preparation is key for dynamic extraction. The rescuers on the ground must be
prepared to take the hook and immediately clip in to continue the extraction.
Once the load is connected and a signal is given by the ground rescuer, the pilot performs a power check,
ensures the load has cleared all obstacles and then quickly transitions to forward flight. With this dynamic
hoist load technique, the load might spin slightly as the helicopter initially takes the HEC load. But as the
helicopter transitions into forward flight and higher speeds, the downwash is increasingly left behind the
aircraft (and no longer in the path of the suspended load).
Dynamic hoist operations offer several advantages, including:

● They reduce the amount of time that the aircraft hovers over the rescue scene, reducing both time
on-scene and time employing high engine power.
● They all but eliminate the possibility of a litter spin during the hoist operation (attending rescuers can
reduce any subsequent modest spin by extending an arm while in flight).
● They provide the pilot more options (in forward flight) in the event that power or the tail rotor
become compromised.
Bob Cockell, Vice-President of Air Rescue Systems, says of dynamic hoisting:

“The benefits of dynamic hoisting are under-utilized for several reasons, including misunderstanding of the technique,
and the mistaken belief that there is necessarily greater risk involved. When correctly performed, dynamic hoist
operations reduce risk through decreased exposure, and the team gains increased situational awareness by performing
checklist functions, pre-door opening safeties and hoist hook-ups prior to arrival at the target. Through completion of
these requisite procedures early on, the team has time to gain composure, reassess the go-no-go statement and choose
alternate tactics prior to taking on the exposure associated with the extended hover.”
Spinning Litters in Hoist Operations

One mistake that pilots and crews often make when a litter
starts to spin is to slow the forward flight in an attempt to give
the crewmembers a chance to correct the spinning problem. In
fact, slowing forward flight is precisely the wrong thing to do.
Ideally, as soon as the pilot has the rescuer and the subject, the
pilot should transition quickly to forward flight, perhaps to 40-
45 knots. In this case, the helicopter outruns its downwash,
slowing any spin of the HEC load. Alternatively, if forward
flight is not an alternative, the hoist operator can reel out cable
while the pilot gains altitude until forward flight is possible, and
the load can then be safely raised.
41
Leadership Knowledge of Rescue Helicopter Capabilities

The leadership of SAR agencies that employ HEC rescue programs must possess a thorough understanding
of the operational complexities detailed above. To achieve and maintain this understanding, leadership
should regularly train with the helicopter rescue teams under their authority. The authority having jurisdiction (AHJ)
must be equally aware of the skills and capabilities of the search and rescue air assets available to them,
whether HEMS or SAR.
Hot-Loading/Unloading and
Power-on Landings
Occasionally, rescue helicopters will need to load and
unload rescuers and patients while the helicopter is on
the ground with rotors turning. This method is called
“hot-loading and unloading,” and refers to the ‘hot’
engine, which is running.
Hot loading and off-loading can increase efficiency - it is

faster to perform repeated shuttles of personnel without
shutting the engine down with each transfer. They can
also allow for landing where fuel, terrain, and impending
weather would render a full engine stop dangerous or
impossible. But the decision to load and unload “hot” is
not without consequence: any operation that requires
rescuers to work or move beneath spinning rotors
increases
risk to
both
helicopter and crew, and so should be avoided when possible.
Rotors can droop if engine RPM is reduced, with the most
pronounced droop at the nose of the helicopter. Shutting down
the aircraft to load personnel or a rescue subject effectively
eliminates the chance that someone or something inadvertently
strikes a spinning rotor. When the team decides that hot
loading or unloading is necessary, rescuers must prepare
carefully, pre-brief and secure loose debris, gear and equipment height in advance.
A power-on landing is a type of hot-loading/unloading where

an unstable landing site makes it impossible for the pilot to
disengage the engine and power-off the aircraft. The pilot
must maintain adequate power to prevent the aircraft from
tipping or rocking in its precarious perch. Because the
engine is not idle during power-on landings, but is powering
the main rotor to hold the aircraft in position, the air drawn
through the rotor is significant. For this reason, rescuers
must anticipate rotor downwash stronger than that
experienced during other hot loading/unloading.
Photo: Charley Shimanski/Air Zermatt
42
One-Skid and Toe-In Landings

One-skid and Toe-in landings are types of power-on landings that
pose even greater danger to rescue teams and those they
attempt to save. These are specialized landings where terrain
makes it impossible for the helicopter to land with both skids
(or wheels) on the ground, necessitating a landing where the
helicopter is perched one on skid with the engine fully engaged.
Photo: Arizona Department of Public Safety A one-skid landing is not a complete landing because the pilot
from AirMed&Rescue Magazine must maintain a full power hover while placing a skid or wheel
on the ground on the side of the aircraft where the rescuers will
load or unload. Prior to positioning the helicopter at the desired one-skid location, the pilot will generally
check controllability, hover out-of-ground effect power levels, and tail rotor authority while also ensuring that
he or she has a clear escape route in the event of a power issue or unexpected wind gust or turbulence.
Even more dangerous than a one-skid landing is a toe-in

landing. In a toe-in landing, the pilot is only able to place
the front tips of the skids (or the nose wheel) on the
terrain, providing contact with the ground only at the
helicopter’s 12 o’clock position. This type of operation is
even more challenging for pilots than are one-skid
landings, since they have to make a dramatic turn to escape
Photo: Pprume.net
the scene in the event of wind or turbulence or
compromised engine power.
Hover Insertion and Extraction

There are situations where technical terrain renders even a one-skid or toe-in landing impossible, but it
remains possible to insert or extract rescuers and the injured while hovering just above the ground. These
operations are often referred to as hover loads.
The Inherent Risks of Hover Loading and

Unloading
Loading and/or unloading in low hover above uneven terrain
exposes all involved to high risk. There are several elements of
low hover that increase risk, to include:
● The helicopter is generally operating at full power, where
there is little margin of error.
● Tail-winds make loading and unloading in hover very
difficult.
● The main rotor blades are close to the ground and at full
Central Okanagan Search & Rescue (COSAR),
Wildcat Helicopters, and Vernon SAR's power, presenting a danger to all near them.
Helicopter Winch Rescue team from YouTube. ● There may be no escape route for the pilot in the event of
compromised engine power.
● Snow can conceal the hazards of terrain. When rescuers move from a helicopter in hover onto snow
terrain, they expose themselves to these hidden hazards.
For these reasons, pilots, flight crewmembers, and rescuers must exercise extreme caution during hover
operations.
43
Safety Considerations for Hover Loading and Unloading
Is a Hover Load/Unload Necessary?

For many reasons, helicopter rescue operations that necessitate loading and/or unloading in hover should be
carefully considered before they are executed. Countless accidents and incidents, including fatal accidents,
have occurred during these types of helicopter rescues. A thorough risk assessment could include questions
such as:
● Does the rescue subject’s condition warrant a high-risk hover load/unload of rescuers and/or the
subject?
● Does the program have significant experience and training in such techniques?
● Is there an alternative (short-haul, hoist)?
● Are there other elements in the risk assessment that should be considered?
For rescue teams that do not perform these types of operations often, these techniques fall into a “high risk,
low frequency” category, a dangerous category that reinforces the need for a thorough risk assessment.
The Importance of Center of Gravity

Hover loading and unloading operations present a
challenge to a pilot’s control of the helicopter’s center of
gravity (CG). If more than one rescuer is boarding the
aircraft during a hover load, the first rescuer on board
must move to the opposite side of the aircraft after
loading to make room for other rescuers. In smaller
aircraft, this movement can cause CG issues, especially
if it is done quickly. To reduce their impact on CG,
rescuers should cross the interior of the aircraft
gradually. Rescuers should be careful to distribute their
weight on board, and if two rescuers are boarding into Charley Shimanski © MRA/ Air Zermatt
the back seat with only one pilot in the front, rescuers
should be careful not to load directly behind the pilot to avoid disrupting the aircraft’s CG. These same
considerations apply for hover egress (unloading).
Keep Extra Gear in a Pack

If a rescuer in a hover load or unload is wearing a rescue harness, he or she should place as much hardware as
possible in a pack to prevent hardware attached to the harness from catching on equipment in the helicopter
interior during ingress or egress.
Know the Specific Aircraft’s Landing Gear

To prevent slipping from the skid and to likely injury, rescuers should make themselves familiar with the
aircraft’s skids. Some skids have a non-stick surface, others do not. It is all too easy to slip when stepping
onto skids wearing 4-season mountaineering boots in very cold weather.
44
Hover Loading and Helicopter Doors

When attempting hover loading in the field, the rescuers must
be very familiar with the operation of the aircraft doors, since
the doors will normally be closed as the helicopter approaches
for the hover load. Each model of helicopter has its own door
handles and operates differently, and it is not safe to assume
that familiarity with one set of aircraft doors will convey
familiarity with another. Hover load operations are no time to
struggle with the doors; rescuers should know how the doors
operate in advance.
Photo:Eva Sophia Shimanski, training with
Helicopter doors are designed in a way that enables them to be Rocky Mountain House SAR and Ahlstrom Air,
removed easily and are therefore fragile and should be opened Canada
G-E-N-T-L-Y. If a rescuer uses too much force to open a
door, the door may literally come off from the aircraft, or
become partially disengaged and inoperable. Similarly,
rescuers should be careful to not pull on any doors or
external components as they enter the aircraft in a hover
load, as these components can become disengaged from the
aircraft if pulled with too much force. Rescuers may be able
to grab onto seat frames, however, in order to gently climb
in. Rescuers should also be aware that hover loading is a
suboptimal way to load a rescue subject who has little or no
experience around helicopters, although certain
Photo: Air Zermatt circumstance may render it necessary.
Sequence for Hover Loading

When attempting a hover load operation on difficult terrain,
rescuers should all huddle together down low on one knee as
the helicopter moves into its final approach. The pilot will
usually move into a low hover with those rescuers at the
helicopter’s nine or ten o’clock position, often on the opposite
side of the pilot. This means that when the helicopter is in
position, the rescuers will not need to take more than one or
two steps to access the skids and doors. Video by Eva Sophia Shimanski, training with
Rocky Mountain House SAR and Ahlstrom Air,
If the pilot wishes to come into low hover directly next to the Canada
rescuers for a hover loading in challenging terrain, there are a
few key rules to follow:
● Once rescuers are in position and the helicopter is on final approach, rescuers should be careful not
to move, and to let the helicopter come to them.
● Most rescue programs will generally follow the same predetermined procedure. (E.g., always loading
on a particular side, etc.) If terrain, wind, or other flight conditions require deviating from that
procedure, rescuers and the pilot need to communicate to create a clearly understood shared plan.
● The pilot may wish to hover somewhat parallel to a slope so that he or she can depart quickly should
need arise. Remember, pilots always look for an “escape route.”
45
When performing hover loading, rescuers should consider this sequence:

● Rescuers should step on to the skid gently, one rescuer at a time.
● When transferring weight from the ground to the skids (or vice versa), rescuers must do it S-L-O-W-
L-Y, transferring their weight gently.
● Rescuers can board in sequence, and should not wait for each rescuer to be buckled into his/her seat
belt before commencing.
● As each rescuer has donned his or her helmet or headset, they should announce that they are “on
comms” with the pilot.
● Once the last rescuer is on board, the doors should be closed, even if seatbelts, helmets, and
communications are not completed.
● Rescuers should maintain a “sterile cockpit” during this operation, limiting their intercom radio
traffic to essential communication.
Hover Unloading
While hover unloading (also known as “egress”) presents
similar challenges to loading in hover, it also requires
different attention to the terrain and aircraft. When
preparing to unload while in hover, rescuers should
carefully assess the terrain, and move deliberately. As
Oliver Kreuzer, a paramedic crewmember and trainer with
Switzerland’s Air Zermatt says, “don’t jump out of a
helicopter like you just escaped from prison. There is a
difference between ‘running down the stairs’ and ‘sneaking
down the stairs.’”
Rescuers who are to be inserted into technical terrain from Photo: Tomas Kika, Air Zermatt/Vertical Magazine
hover will most often remain in place on the ground
directly outside the aircraft until the helicopter departs. In the unlikely event that the pilot prefers that
rescuers move farther from the aircraft, rescuers must communicate clearly with the pilot what actions they
intend to take once on the ground. Will they immediately descend downhill from the aircraft, and if so, in
which direction? The pilot must know what the rescuers will do once on the ground so that he or she can
determine the safest means to fly from the scene. In general, however, the safest course of action rescuers can
take is to remain on the ground directly next to the aircraft until the aircraft has departed.
As the helicopter begins to hover, rescuers must determine if the terrain is safe to enter before exiting the
aircraft. Rescuers must be careful not to insert themselves into terrain that will cause them to fall.
If many rescuers aboard a smaller helicopter are going to hover exit, those rescuers should be careful to NOT
move at the same time across the helicopter to the exit door. As noted above in the discussion of hover
loading, the shifting of weight across the helicopter cabin can compromise the pilot’s ability to manage the
aircraft’s center of gravity.
46
Sequence for Hover Unloading

When performing hover unloading, rescuers should consider
this sequence:
● Confirm that the proposed drop zone is safe. Once
confirmed,
● The rescuer near the departure-side door should
announce to the pilot the intention to open the door
and begin egress. Video by Eva Sophia Shimanski, training with
● Rescuers should remove seat belts first and Rocky Mountain House SAR and Ahlstrom Air,
communications equipment last, maintaining Canada, narrated real-time by veteran pilot Kyle
Wadden
communication with the pilot for as long as possible.
● Once out of their seatbelts, rescuers should fasten their
seatbelts behind them to avoid any loose equipment hanging outside the door.
● As with loading, rescuers should move carefully and slowly, recognizing how their shifting weight can
complicate control of the aircraft’s center of gravity.
● When possible, rescuers should gently step off the skids onto the ground to avoid sudden shifts of
weight on the aircraft, transferring their weight from the skids to ground S-L-O-W-L-Y.
● The last rescuer should close the door, if instructed to do so by the pilot. With certain models of
aircraft, there is a latch on the sliding doors that can lock the door in the open position. This latch is
typically located near the sliding rail at the top of the door, a location that can make it difficult, if not
impossible, for the rescuer to reach after exiting he aircraft.
● After the aircraft exits, rescuers on the ground should recognize that the terrain remains incompletely
known. They should therefore move slowly and deliberately to further evaluate the terrain. Is it safe
to comfortably exit the drop zone? Are all rescuers secure in this terrain? Should rescuers quickly
clip in to any natural anchor or to a camming device?
Complex Loading and Unloading - Is There Another Way?

Each of the loading and unloading procedures detailed in this lesson are dangerous and afford little margin
for error. Moving into and out of a helicopter in hover, or one perched on a single skid, requires movement
on precarious terrain under rotor blades spinning at full power. Rescue teams should avoid these maneuvers,
if at all possible, and undertake them only after careful risk analysis. Are there alternate LZs available that are
safer, and reduce the need for this complex ingress/egress? Can the patient be moved to a more suitable
location? Pilots and rescue crewmembers must not allow themselves to become blind to alternative routes of
action. There may be more than one way to perform the mission.
47
Winter Landings in Snow
Using a Rescuer as a Point of Reference

Landing a helicopter on snow (or dust) is difficult because
the rotor downwash carries the snow into the air where it
can obscure sight and vertical reference and lead to spatial
disorientation. For this reason, a pilot may wish to have a
“visual reference” in a winter landing zone (LZ), ideally a
rescuer who remains in the LZ at the location the helicopter
will land.
The sequence for using a rescuer on the ground as a visual

reference is as follows:
● The “target” rescuer stands in the proposed LZ, Photo: Charley Shimanski
holding his or her arms in the classic “Y” signal.
● As the helicopter moves into final approach, the rescuer drops his or her arms to the side and drops
to one (and only one) knee. (Dropping to a single knee allows the rescuer to move or change
position more quickly and with greater ease than when kneeling on both knees.)
● The pilot will fly directly to the rescuer and land such that the rescuer is kneeling essentially at the
nose of the helicopter, often close enough to reach out and touch the nose when the helicopter
touches down. For this reason, it is critical that the rescuer not move when the aircraft makes its
final approach.
In lieu of a rescuer marshalling in close proximity to the landing helicopter, a weighted pack can be placed in
the same location, performing the same role. The pilot maintains visual reference with the pack through the
chin bubble all the way to touchdown, which reduces risk to personnel.
Photos: Dale Atkins, Alpine Rescue Team
It is important to recognize that snow landings may need to be power-on landings, since the quality and
firmness of the snow - and thus its ability to support the weight of the aircraft - may be difficult to judge. For
this reason, the target rescuer should describe the ground snow conditions to the pilot before the helicopter
lands. Rescuers can also bring themselves and a carefully prepared rescue subject onto the LZ to serve as the
48
pilot’s visual reference in a winter operation. This technique

puts rescuers and helicopter at higher risk, and so should be
practiced by only the most experienced programs.
Static Electricity in Winter Hover Loads

When helicopters attempt hover loading in snow conditions,
the blowing snow can increase the amount of static electricity.
To prevent a dangerous electrical discharge to rescuers, the Video courtesy Red Bull Media/Air Zermatt;
pilot may need to electrically-ground the helicopter by edit by Charley Shimanski
lowering it into contact with the snow on the earth.
49
5
Part
Part 5 – Search and Rescue Helicopter

Operations
HEC Rescues on Near-Vertical Walls
Throughout the world, there are public lands with vertical
rock walls celebrated by the climbing community. These
vertical faces summon climbers from far and wide to test
their skill, and force rescue programs to attempt highly
technical rescues when misfortune strikes. These rescues
require specialized techniques to insert highly-trained
helicopter rescue mountaineers into a complex technical
scene to package and extract an injured climber. In these
cases, the rescuer is often delivered by short-haul or hoist to Photo: Yosemite National Park Search and
the accident site. The rescuers must then anchor themselves Rescue
to a safety anchor on the wall in a carefully choreographed
but rapid maneuver to minimize the amount of time that the rescuer is connected to the aircraft and the
rock face at the same time.
The same challenge exists when a rescue helicopter comes to an accident scene to extract a subject in a
rescue litter, and the attending rescuer. On highly technical
terrain, the litter will be tethered to an anchor on the wall when
the helicopter returns to extract the subject and litter attendant.
As with rescuer insertion, transferring the litter and attendant
from the wall to the HEC line must again be a carefully
choreographed and rapid maneuver to minimize the amount of
time that the rescuer and litter are connected to the aircraft and
wall at the same time.
50
A helicopter cannot hover directly above rescuers and injured

subjects on a completely vertical wall, complicating insertion
and extraction from this type of terrain. These cases require
highly trained rescue units to employ specialized and
complex procedures to successfully transfer the rescuer litter
and litter attendant to the helicopter. Yosemite National
Park Search and Rescue (YOSAR), for example, has
developed the “Offset Technique” whereby a short-haul line
is pulled over by rescuers at an offset angle to the wall.
Rescuers then quickly attach their helicopter load line just as
they “cut” the litter/attendant-dedicated attachment from the
wall anchor, allowing the rescuer and subject to transfer to
the helicopter as it flies away from the wall.
For these types of rescues, there are different types of systems

to manage the complicated load transfer from the ground to the
helicopter. As previously mentioned, Petzl has developed its
“Lezard” for this purpose, while some programs may use a Yosemite National Park Search and Rescue
Munter/Italian hitch or simple cutaway to accomplish the
transfer. It is worth restating that this load transfer is complicated and likely to lead catastrophic injury if
performed incorrectly. For this reason, the YOSAR team trains this procedure far more often than they use
it. A nuanced description of this technique is beyond the scope of this training.
Rotor clearance from the rock wall is also a critical concern on rescues in near-vertical terrain. While the
Hoist Operator is often charged with evaluating rotor clearance during the operation, the rescuer on the wall
can call also out the rotor clearance (although this added responsibility runs the risk of task overload).
An advantage of helicopter rescue in steep terrain is the vertical space afforded sheer rock face. If there is a
problem while the helicopter is at full-power hover, the pilot can escape by turning the aircraft and diving to
pick up forward airspeed. In general, the pilot will hover sideways to the mountain, facing the wind, and can
fly into that wind when making an escape.
Night Operations
Hoist operations at night present an even greater level of
operational risk and challenge than daytime operations. Limited
visual reference and the reduced capability of the human eye may
cause pilot disorientation, resulting in unstable positioning of the
aircraft. For rescuers on the ground, darkness complicates work
already rendered challenging by mountainous terrain. Rain, snow,
moonless night and the absence of ambient light all heighten the
risk inherent to nighttime operations.
For all of the reasons above, rescue crews should carefully evaluate
whether a night operation is truly necessary. This determination
should start with the patient’s condition, since many rescue subjects
Photo: US Army
are stable enough that they can withstand a few hours of care
delivered in the field by rescuers as they wait for daylight to
perform a well-lit operation.
51
Night Vision Goggles

To augment vision during night operations, helicopter rescue
teams use night vision goggles (NVGs). As their name suggests,
NVG enhance vision at night and thus increase the aircrew’s
overall situational awareness. Pilots and crewmembers alike find
that the “aided” vision from NVGs is most effective when
combined with their “unaided'' natural vision (without looking
through the NVGs). Since the NVGs are suspended a short
distance in front of, and not in direct contact with, the user’s eyes,
a user can switch from aided to unaided vision without necessarily
removing the NVGs.
Advantages of NVGs NVG training web site example by

www.Helistream.com
NVGs offer distinct advantages for SAR operations. For
example, an SAR team using NVGs might be able to find a lost
subject at night that would remain invisible during the day because NVGs can more easily detect a light
source that would be faint to the unaided eye, especially against the background of remote terrain. A cell
phone display, while not necessarily a bright light to the unaided helicopter searcher, is easy to see under
NVGs. Crewmembers using NVG will also be able to detect even a small signal fire with ease. And as
noted above, NVGs allow the crew to increase their situational awareness during nighttime operations. A
hoist operator equipped with NVGs can see obstacles or hazards that may remain hidden to the naked
eye despite the use of rescue or aircraft lights.
Disadvantages of NVGs
There are many challenges to using night vision goggles, which include:
● The field of view is only 40 degrees, which requires the operator to continually move his or her
head to see all possible hazards.
● NVGs greatly reduce the operator’s depth perception, a significant limitation during hoist operations.
(Hoist operators should move from aided to unaided vision periodically to benefit from both
perspectives.)
● Operators may believe that all obstacles and hazards are easier to see under NVGs, since NVGs not
only illuminate but exaggerate light sources. NVGs may not improve the visibility of hazards such as
wires, however. The newer white phosphor NVGs offer a significant improvement in visibility, but
aircrews must continue to remain vigilant to the technology’s limitations.
Since NVGs are sensitive to lighting inside the aircraft, programs must develop onboard displays and
lighting compatible with the goggle technology.
Program Considerations Prior to Developing Night Hoist Operations

Night hoist operations require extensive and continual training, training that might be hard to justify
depending on the program’s budget and the operational demand for nighttime operations. Absent adequate
training and current experience, the danger of night hoist operations become more dangerous still. Program
managers should consider the many elements of a night rescue program and their alternatives before electing
to begin one.
If a HEC program has decided to begin night operations, an argument can be made for keeping these
operations as simple as possible, using lights and avoiding the use of NVGs - and waiting for daybreak to
attempt complex rescues.
52
Night Operations for Human External Cargo

Programs
HEC programs that carry out operations at night should set

clear training standards and experience currencies to help
ensure these operations are as safe as they can be. These
standards can include:
● Course requirements for pilots, mechanics,
crewmembers, and rescuers.
Arizona Department of Public Safety,
● Hands-on training requirements for pilots, AirMed&Rescue Magazine. Photo by Barry
mechanics, crewmembers, and rescuers. Smith
● Minimum experience required before pilots,
mechanics, crewmembers, and rescuers can participate in live operations.
For HEC hoist operations at night, ongoing training is critical. Rescuers must be able to demonstrate
proficiency to remain current and mission-ready. Operational proficiency with NVGs also requires consistent
training.
Night Operation Considerations for the Rescuer on the Hoist

An HEC rescuer should be rated by the program for day operations first, and should have significant
experience in day operations prior to training in night
operations. The rescuer should then receive training in
night hoist operations. Prior to transitioning to night
operations, the rescuer should have performed a minimum
number of operations in accordance with the program’s
requirements.
Night Operation Considerations for the Pilot

For pilots operating at night, experience with both NVGs
and daytime hoist operations is key. By obscuring a
pilot’s horizontal and vertical reference, night renders the
essential ability to hold a hover during a hoist Photo: Dale Atkins, Colorado Hoist Rescue operation
more difficult than during the day. NVGs can Team mitigate this
loss of visual reference, but, as noted above, requires
training in their use and an appreciation of the technology’s
limitations.
Night Operation Considerations for the Onboard

Crewmembers and Hoist Operator
Aircrew should receive training in nighttime operations, to include
content similar to that received by pilots. Crewmember training can
include:
● NVG initial course (length of course would be dependent
on experience).
● Mountain rescuer NVG course (including a minimum
Photo: AirMed&Rescue Magazine by Barry
number of flight hours in summer and winter flights). Smith
53
Many programs do not allow crewmembers to perform night hoist operations for a minimum number of
months from initial NVG rating while performing only training operations.
Night Operations Hoist Procedures

Hoist procedures may vary depending on the pilot and
crewmembers’ familiarity with the area of the rescue.
Responding to the Scene

While responding to the rescue scene, all crewmembers
should be employing NVG. While flying using
goggles, the pilot should overfly the scene to improve the
Photo: Airbus Helicopters
team’s situational awareness and to search for any
obstacles.
When en route to the rescue site, crewmembers should consider if, when, and how to activate the search
light. Some use the searchlight en route while others do not.
Once on the scene the pilot and crew may elect to use the search
light to aid in reconnaissance and provide additional ambient
light or to increase the functionality of NVGs. Once the crew
has developed sufficient unaided visibility of the ground, they
should inform the pilot.
The Hoist Operation at Night

NVGs mounted on
a helmet may prove
a hindrance to Photo: LTG Global web site
dropping into a
scene by hoist or hoisting back into the helicopter. Once the
aerial reconnaissance is complete, the rescuer may wish to
remove the goggles and stow them in the aircraft or pack them
in his or her backpack to hoist in with them.
Lighting Considerations
Lighting of the Rescue Scene
Most aircraft light their belly lights during night operations to
illuminate the scene for rescuers and to make the hoist
operator’s precision work less difficult. HEC programs should
evaluate whether the belly lights on its aircraft provide adequate
lighting at night. Some belly lights/search lights may not
provide enough illumination, especially as the length of the
hoist increases.
On vertical wall rescues at night, the pilot may choose to use

the search light for aide visual reference while in hover. This
light may be too bright for the rescuers below, but essential for
Photo: Charley Shimanski the pilot. When possible, the pilot will consider engaging the
helicopter autopilot and hold/auto hover.
54
Hoist Operators
Hoist operators should alternate between NVG and unaided vision while scanning the scene to compensate
for the limited depth perception afforded by NVG. They may choose to use NVGs to scrutinize objects in
the distance and to identify hazards and then transition to unaided vision during the execution of hovering
operations when depth perception becomes critical. To more efficiently make this visual transition, the hoist
operator should consider adjusting googles to a high-up-and-out position. Comfort with the transition
between NVGs and unaided vision empowers the hoist operator to move seamlessly to the naked eye should
the goggles fail.
In some programs, the hoist operator will work without NVG. These programs believe the helicopter’s lights
with the hoist operator’s unaided vision offer better situational awareness and depth perception.
Lighting for the Rescuer

During the execution of night hoist operation, the rescuer on the
hoist should be equipped with bright lighting, usually helmet-
mounted. Some rescue helmets are equipped with rail systems that
include helmet-mounted lights.
Lighting of Equipment and the Scene

Many rescue programs use “chem-lights” on the hoist hook to
make the hook more visible to rescuers and the hoist operator.
Other programs may use lighting from the hoist bumper, such as Photo: AirMed&Rescue Magazine by Barry
dual headlamps that point downward. Smith
Rescue teams also should consider dropping chemlights from the aircraft to the ground to provide additional
reference of distance and terrain. In addition, a V shape of reflective tape on top of the rescuers’ helmets can
serve as a visual reference for the hoist operator (The “V” shape enables the hoist operator to recognize
which direction the rescuer is facing.) Rescuers may also have flashlights and/or chem lights mounted to their
rescue vests.
Rescuers should keep light discipline while on the ground and should generally turn off lights when feasible
as they approach the aircraft. This reduces the chance that an exterior light beam creates a hazard in the
cockpit, blinding pilot or crew, or interfering NVGs.
Communications – Handheld Radios and Hand signals

Hand signals are difficult to see when lighting is poor. The hoist operator is usually unable to see hand
signals from the rescuer on the hoist, and the bright lights of the fuselage can make it difficult for the rescuer
to see the hoist operator when he or she looks up at the aircraft. For this reason, rescuers should have a
separate two-way radio to ensure effective communication. The rescuer should perform a radio check of the
two-way radio prior to exiting the aircraft on the hoist.
55
In some programs, rescuers connect chemlights to their wrists so that simple hand signals can be understood.
There should be standardized hand signals for normal, abnormal, and emergency procedures, particularly in
the event of radio failure.
Risk Management Considerations for Night Operations

While night hoist operations may be an option for many HEC programs, teams should always ask whether it
is possible to stabilize the rescue subject in the field for the remaining hours of darkness and conclude the
rescue operation during daylight. If immediate retrieval from the field is not necessary, the arrival of daybreak
will remove the limitations - and the risk - of night operations.
CONCLUSION
The development of SAR helicopters capable of inserting and extracting rescuers by hoist and short-haul has
saved human lives. HEC operations make it possible to perform rescues where terrain, weather and
geography would otherwise render such rescues impossible. This remarkable ability comes at the cost of risk
to helicopter, pilot, aircrew, rescuers and those they save; a risk that cannot be overstated. This text has
attempted to address the essential components of helicopter rescues that include these specialized rescue
techniques, but is not and has never intended to be a substitute for complex, elaborate, and consistently-
practiced hands-on training.
ACKNOWLEDGEMENTS
First and foremost, the authors wish to acknowledge and thank Ken Phillips, former Branch Chief of Search
and Rescue, National Park Service (NPS) and author of “Helicopter Rescue Techniques – Civilian Public Safety and
Military Helicopter Rescue Operations.” The inspiration for this training comes largely from Ken’s lifelong
dedication to training rescue professionals in advanced helicopter rescue techniques. We credit the foundation
of much of this material to Ken’s inspirational work.
The author wishes to also acknowledge Oliver Kreuzer, flight paramedic with Air Zermatt and instructor with
the Air Zermatt Training Center in Switzerland for his inspiration, dedication, and thoughtful instruction.
We also recognize the following individuals who supported the development of this training material:
 Eva Sophia Shimanski; Photographer, videographer, and rescue subject
 Dale Atkins; Alpine Rescue Team, and Colorado Hoist Rescue Team
 Kyle Wadden; Lead Pilot, Ahlstrom Air
 Oyvind Henningsen, Coordinator and Rescue Technician, Snohomish County Helicopter Rescue
Team
 Clayton Horney, Colorado National Guard
 Larry Koren, Chief Pilot; Bernalillo County Sheriff’s Office
 Christiane Leitinger; Chief Editor
 Casey Ping, Veteran HEMS and HEC Program Director
 Jason Williams; International Mountain Medicine Center, University of New Mexico
56
Additional Materials
● “Helicopters in Search and Rescue - Basic Level” - by Charley Shimanski/Dr. Charlie Mize/MRA; a
Mountain Rescue Association certificate course covering the basics in helicopter safety,
communication, helicopter management,
● “Helicopters in Search and Rescue - Intermediate Level” - by Charley Shimanski/Dr. Charlie
Mize/MRA; a Mountain Rescue Association certificate course covering helicopter landing and
takeoff areas, heliport management, safety, communication, helicopter management
● “Helicopter Rescue Techniques – Civilian Public Safety and Military Helicopter Rescue Operations”
- Ken Phillips; former Branch Chief of Search and Rescue, National Park Service (NPS),
● HeliNOTS (Helicopter Non-technical Skills) is a series of behavioral marker systems, developed by
Oliver Hamlet, Dr Amy Irwin, Professor Rhona Flin and Nejc Sedlar of the Applied Psychology and
Human Factors Group of the University of Aberdeen.,
● Federal Aviation Administration (USA) Advisory Circular AC_133-1B, which also provides guidance
and information for certificated rotorcraft external-load operators.
57

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Helicopters

In Search and Rescue

Mountain Rescue Association

HELICOPTERS IN SEARCH AND RESCUE

By Charley Shimanski and Dr. Charlie Mize

About the Authors

Dr. Charlie Mize

Contributors: Oliver Kreuzer and Air Zermatt

Part 1 – Rescue Helicopters and Crew

Photo: Air Zermatt

Human External Cargo (HEC)

The US Federal Aviation Administration has formally

In Part One, we define the types of rescue helicopters used,

Types of Rescue Helicopters

For simplicity, we will refer to both of these types of

Each type of helicopter is critical in life-saving SAR Photo: Charley Shimanski

Search and Rescue (SAR) Helicopters

SAR Personnel on board

Specialized Helicopter Rescue Equipment

Emergency Medical Services Helicopters (HEMS)

For some time, HEMS programs have trained with local

SAR and HEMS Helicopters

In a few cases, rescue agencies have both types of rescue

Definition of Rescue Helicopter Personnel

If there is only a single pilot, that pilot is the PIC. The

Non-Pilot SAR/HEC Personnel

Terms most commonly used include:

Air Operations Ground Support Team Members

Medic / HEMS Crewmember

Helicopter Hoist Operator (aka “HHO” or “HO”)

Types and Definitions of HEC Systems

Photo: Priority 1 Air Rescue Photo: Charley Shimanski

Vertical Reference and the Differences between Hoist and Short-Haul

Both short-haul and hoist can be performed under high fidelity

While hoisting operations reduce the time that rescuers are

Most hoist programs are designed to lift rescuers and a

Difficulties with Hoist Operations

Short-haul programs offer several advantages when

Photo: Bild am Sonntag Magazine/Christian Spreitz

Mission Pre-Planning and Inter-

Ideally, several rescuers input their personal “ratings” into the

Risk: SPE, ORMA,

RADeMS (ON THE

Post Event Debrief

The overall goal of any rescue review is to improve

Lessons Learned? Not Necessarily

Part 2 – Equipment for HEC Operations

Standard Equipment for Both Hoist and Short-Haul Operations

Helicopter Hoist Hook

It is important that rescue personnel connect

should strongly consider its use. According to the US Federal

According to a FAA Safety Alert for Operators (SAFO-16015):

Winching and longline operators should:

Static Discharge Cables

Static Discharge Cables are specialized metal cables, generally

Rescuers who do not employ static discharge cables should first

Although the cable discharges its static electricity when it touches